The evaluation of effect of coronary collateral formation on left ventricular function by using strain echocardiography

The functional importance of presence of collaterals in coronary artery disease isn?t known exactly. Positive effects of developed collaterals on ischemia and left ventricule functions is generally accepted, although certain results wasn?t obtained. We aimed to compare strain echocardiography that we think evaluate ventricule functions more correct, and the other echocardiographic methods in patients with or without angiographic developed collaterals.İn this study non acute coronary syndrome 45 patients with determined occlusine in LAD over %90 (average age 63±10,8 years)(9 female and 36 male patient) were included. PW Doppler, Tissue Doppler and strain echocardiography applied to patients, detailed systolic and distolic function parameters, peak strain values and strain index was measured. Collateral vessel developping according to Rentrop classification, grade 0-1 patients were determined as group I, grade 2-3 patients determined as group II.İn group I there were 6 patients with DM. Group II that collateral development was better there wasn?t a diabetic patient (p=0,02). İn group II time of MI significantly longer than group I ( 29 month versus 18 month, p= 0,003). İn group II patients who have better developed collaterals LVESD was lower (p:0,04) and ejection fraction was significantly higher. İn group I patients MLA DT (p=0,004) and MSA DT were longer (p=0,03). Patients with weak developed collaterals in group I WMSI was higher (2,1±0,5 versus 1,7±0,3; p= 0,005). İn group I peak strain values in almost all of the segments was lower than group II ; in basic anteroseptal (p=0,04), mid septal (p=0,01), apical septal (p=0,02) segments determined as significantly lower. Also ?peak I value was significantly lower in group I ( p=0,02). In midseptal (in Group I %20,8 versus %0 in group II ; p=0,05), apical septal (in Group I %70,8 versus %38,1 in group II; p:0,04) and apical inferior (in Group I %66,7 versus %33,3 in group II; p=0,04) segments, higher number of post systolic shortness was determined patients who have weak developed collaterals versus patients who have better developed collaterals. İn examination of Group I, it was observed that PSSI have possitive correlation with LVEDV (r=0,4 p=0,05) , LVESV (r=0,47 p=0,01) and WMSI (r=0,64 p=0,001); have negative correlation with EF (r= -0,57 p=0,03) and MSA S (r= - 49,8 p=0,01). İn examination of Grup II it was observed that PSSI have positive correlation with LVESD (r=0,5 p=0,01) and LVESV (r=0,52 p=0,01), have negative correlation with MSA S (r= -0,45 p=0,03) .Finally; with examination of both conventional echocardiographic methods and strain echocardiography determined better left vetriculer functions in patients who have better developed collaterals.Key words: strain, collaterals, post systolic shortness