Assessment of coronary blood flow in non-ischemic dilated cardiomyopathy with the TIMI frame count method

Abstract

Assessment of coronary blood flow in non-ischemic dilated cardiomyopathy with the TIMI frame count method Methods: This retrospective study included 62 patients with idiopathic dilated cardiomyopathy (34 men, 28 women; mean age 59.7±10.6 years) and 62 control subjects without dilated cardiomyopathy (28 men, 34 women; mean age 56.6±9.8 years). All patients and control subjects had angiographically proven normal coronary arteries. Dilated cardiomyopathy patients had a left ventricular ejection fraction <45%. The TIMI frame count was determined for each major coronary artery in each patient. Statistical analysis was performed using Student's t test, Chi-square test and Pearson correlation analysis.Results: The TIMI frame counts for each major epicardial coronary artery were found to be significantly higher in patients with idiopathic dilated cardiomyopathy compared to control subjects (corrected TIMI frame count for left anterior descending coronary artery: 37.0±12.5 vs 28.7±11.6, respectively, p<0.001; left circumflex coronary artery: 37.7±12.1 vs 31.0±12.5, respectively, p=0.003; right coronary artery: 37.4±12.6 vs 30.7±11.6, respectively, p=0.003). Mean TIMI frame count had significant although weak positive correlation with left ventricular end-diastolic diameter (r=0.350, p<0.001) and left ventricular end-systolic diameter (r=0.358, p<0.001). Conclusion:We have shown that patients with idiopathic dilated cardiomyopathy and angiographically normal coronary arteries have higher TIMI frame counts for all three coronary vessels, indicating impaired coronary blood flow, compared to control subjects without dilated cardiomyopathy. (Anadolu Kardiyol Derg 2010 December 1; 10(6): 514-8)

Documentation of impaired coronary blood flow by TIMI frame count method in patients with atrial fibrillation

“…It has been reported that TIMI frame count was correlated with flow velocity measured with Doppler guidewire or transthoracic Doppler echocardiography during baseline conditions or hyperemia [16,17] and this measurement could be used as a surrogate marker for epicardial coronary blood velocity and microvascular status [18]. In patients with normal epicardial coronary arteries, high TFC values have been reported in small-vessel disease as early manifestation of atherosclerosis, in patients with metabolic syndrome, aortic stenosis, idiopathic dilated cardiomyopathy, chronic obstructive pulmonary disease or end-stage renal disease [19][20][21][22][23]. To date, there are no data concerning application of TFC method in the assessment of coronary blood flow in AF patients, and correlations between clinical and echocardiographic characteristics and mean TFC were not elucidated.…”