Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

Zhu, Xiaogang; Shen, Hua; Gao, Fei; Wu, Shenshen; Ma, Qian; Jia, Shijie; Zhao, Ziwei; Tong, Shan; Zhang, Zhihao; Zhou, Yujie

doi:10.1155/2019/9168153

Cited by 19 publications

(17 citation statements)

References 19 publications

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“…55% of the study population was male but there was no relation established between sex and CSFP in this paper. Although previous observational studies have concluded that these patients have good prognosis, Zhu et al revealed that an age above 50 and dyslipidemia are associated with adverse outcome in patients with CSF [11]. The mean age of the CSF group was 53 and the groups differed in terms of LDL and total cholesterol levels in our study.…”

Section: Discussioncontrasting

confidence: 69%

Yüksek beta-2 mikroglobulin düzeyleri koroner yavaş akım fenomeni için öngördürücü olabilir

Abacioğlu

Kaplan²

2020

Acta Medica Alanya

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Bu yazının amacı, daha önce ateroskleroz ile ilişkili olduğu saptanan bir protein olan β-2 mikroglobulin (β-2M) plazma seviyeleri ile koroner yavaş akım varlığı arasındaki ilişkiyi incelemektir. Gereç ve Yöntemler: Göğüs ağrısı ile kardiyoloji polikliniğine başvuran ve koroner anjiyografiye yönlendirilen 124 olgu incelendi. 66'sında normal koroner arterler, diğerlerinde koroner yavaş akım vardı. β-2M seviyesini belirlemek için venöz kan örneklerinden elde edilen plazma numuneleri toplandı. Yavaş akım sınıflandırmasını değerlendirmek için TIMI kare sayısı (TFC) kullanıldı. Bulgular: Koroner yavaş akımlı hastalarda beta-2 mikroglobulin düzeyleri sağlıklı kontrollere göre (sırasıyla 2042.0 ± 660.2 ve 1692.7 ± 403.4 ng / mL) daha yüksekti ve fark istatistiksel olarak anlamlıydı (p < 0.001). β-2M düzeyleri TFC ile pozitif korelasyon gösterdi (r= 0.262, p = 0,003). Gruplar β-2M, LDL ve total kolesterol açısından farklılık gösterse de, işlem karakteristik eğrisi (ROC) analizi, çalışma popülasyonumuzda koroner yavaş akım varlığını tahmin etmede LDL ve total kolesterole kıyasla β-2M'nin daha güçlü öngörücü değerini göstermiştir (ROC eğrisinin altında kalan alan [AUC] 0.632, 0.581 ve 0.748; p=0.025, p=0.061 ve p<0.001 sırasıyla). Sonuç: Yüksek serum beta-2 mikroglobulin düzeyleri yavaş akım varlığını değerlendirmek için bir biyobelirteç olarak kullanılabilir.

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Section: Discussioncontrasting

confidence: 69%

Yüksek beta-2 mikroglobulin düzeyleri koroner yavaş akım fenomeni için öngördürücü olabilir

Abacioğlu

Kaplan²

2020

Acta Medica Alanya

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“…CSF is a significant angiographic complication (15)(16)(17) that is usually characterized by an overlap between the injection of contrast medium in a coronary angiography and when this dye passes through the coronary artery (18). CSF is a common disease (19) that is more easily recognized in patients with acute coronary syndrome (20,21).…”

Section: Discussionmentioning

confidence: 99%

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

2021

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Background: To explore the relationship between coronary slow flow (CSF) and both matrix metalloproteinase-9 (MMP-9) and soluble cluster of differentiation 40 ligand (sCD40L).Methods: Between July 2016 and September 2019, 80 patients suspected of having coronary heart disease due to chest tightness or other symptoms of chest pain and discomfort were admitted to Nanjing Jiangbei People's Hospital and, following a coronary angiography, were diagnosed as having CSF. These patients were assigned to the coronary slow flow phenomenon (CSFP) group. The control group, or normal coronary flow (NCF) group, consisted of 80 patients with normal coronary angiography results. Following group assignment, enzyme-linked immunosorbent assays (ELISAs) were used to measure and compare the serum levels of sCD40L and MMP-9 between the two groups.Results: Serum levels of sCD40L and MMP-9 in the CSFP group were significantly higher than those in the NCF group (P<0.05). Additionally, serum levels of adhesion molecules and C-reactive protein (CRP) in the CSFP group were significantly higher than those in NCF group (P<0.05). There was a positive correlation observed between sCD40L levels and adhesion molecule levels in the CSFP group, however, there was no such correlation observed in the NCF group. The CSFP group also had a significantly higher corrected TIMI frame count (CTFC) compared with the NCF group (P<0.05).Conclusions: Serum MMP-9 levels were higher in patients with CSF, and MMP-9 levels were positively correlated with CTFC. This suggests that chronic inflammation may play a role in CSF pathogenesis and that atherosclerotic plaques may be present in the coronary arteries of CSF patients. Additionally, serum levels of sCD40L, adhesion molecules, and CRP were higher in CSF patients, and CRP levels were positively correlated with CTFC. Adhesion molecule expression is promoted by sCD40L. Increased levels of sCD40L may therefore promote the development of CSF.

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“…Clinical Implications. The SCFph is not without clinical consequences, as reported [ 38 ]. Angina is the major clinical complaint, confirmed in our SCFph series.…”

Section: Discussionmentioning

confidence: 56%

Hidden Coronary Atherosclerosis Assessment but Not Coronary Flow Reserve Helps to Explain the Slow Coronary Flow Phenomenon in Patients with Angiographically Normal Coronary Arteries

et al. 2022

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The significance of the slow coronary flow phenomenon (SCFph), as visualized in patients (pts) with angiographically normal coronary arteries, is controversial. Absolute coronary flow reserve (CFR) in the left anterior descending coronary artery (LAD), non-invasively assessed by a transthoracic color-guided pulsed-wave Doppler (E-Doppler TTE), is a reliable parameter to assess coronary microcirculatory dysfunction (CMD). Mild and angiographically hidden epicardial atherosclerosis (Hath), as visualized by intracoronary ultrasound (IVUS), which could be the clue to atherosclerotic coronary microvascular involvement, has never been investigated together with CFR in patients. This study was aimed at assessing the value of CFR and HA in explaining the SCFph. Methods. Both non-invasive assessment of CFR in the LAD and corrected TIMI frame count assessment of the coronary contrast runoff were performed in 124 pts with angiographically normal coronary arteries. Among the whole group, 32 patients also underwent intracoronary ultrasounds in the LMCA and LAD, and the maximal plaque burden was assessed (Lesion external elastic (EEM) cross sectional area (CSA)—Lesion Lumen CSA/Lesion EEM CSA * 100). We found that 24 of the 124 pts (group 1) had the SCFph and the remaining 100 had a normal runoff (group 2). CFR, evaluated in both groups, was not significantly different, being 2.79 ± 0.79 (Mean ± SD) in group 1 and 2.90 ± 0.8 in group 2 (p = ns); in the pts also examined by IVUS (32 pts), the SCFph was always associated with hidden atherosclerosis, and a plaque burden of ≥33%. On the contrary, in the normal runoff group, any grade of PB was observed (from no athero to a PB > 70%) and remarkably, 10 pts had no signs of athero or just a minimal plaque burden. This resulted in a ROC curve analysis in which PB < 33% had a high negative predictive value (100%) in ruling out the SCFph. In addition, considering a CFR value < 2.21 as an index of coronary microcirculatory dysfunction, we found CMD in 15 pts (15%) in group 1 and in 7 pts (29%) in group 2 (p = ns). In conclusion, the SCFph is strongly connected to epicardial athero to the extent that the absence of hidden coronary athero has a very high negative predictive power in ruling out SCFph. CFR that is based on an endothelium-independent mechanism remains fairly normal in this condition. An endothelium-dependent microcirculatory constriction at rest due to atherosclerotic involvement of the coronary microvascular network is a possible explanation of the SCFph.

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Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

Cited by 19 publications

References 19 publications

Yüksek beta-2 mikroglobulin düzeyleri koroner yavaş akım fenomeni için öngördürücü olabilir

Yüksek beta-2 mikroglobulin düzeyleri koroner yavaş akım fenomeni için öngördürücü olabilir

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

Hidden Coronary Atherosclerosis Assessment but Not Coronary Flow Reserve Helps to Explain the Slow Coronary Flow Phenomenon in Patients with Angiographically Normal Coronary Arteries

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