Vascular endothelial function in patients with slow coronary flow.
BACKGROUND
Slow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear.


METHODS
The aim of the study was to determine endothelial function in patients with SCF using a flow-mediated dilatation (FMD) technique in the brachial artery.


METHODS
Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count (CTFC) method. Endothelial function was studied in 27 patients with SCF (23 men, four women, mean age 47.6+/-8.7 years) and in 30 people with normal coronary flow (NCF) (22 men and eight women, mean age 47.5+/-7.4 years).


RESULTS
The flow-mediated diameter increase in the SCF group was significantly smaller than that in the NCF group (3.48+/-0.10% compared with 9.11+/-0.10%, P < 0.001). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and people with NCF (16.8+/-1.1% compared with 17.1+/-1.1%, P = 0.87). Simple regression analysis showed that mean CTFC (CTFC(m)) was strongly and inversely related to the percentage of FMD (r = -0.29, P < 0.01) in all participants. When the patients with SCF were excluded, CTFC(m) was still inversely related to the percentage of FMD (r = -0.36, P < 0.05). CTFC(m) was also inversely related to NTG-induced dilatation in the 57 participants (r = -0.23, P < 0.05). Multiple regression analysis showed that CTFC(m) was inversely related to the percentage of FMD only (r = -0.37, P < 0.05).


CONCLUSIONS
These findings suggest that endothelial function is impaired in people with SCF and that CTFC correlates well with endothelial dysfunction.
Sezgin
Alpay Turan
AT
Department of Cardiology, Inonu University, Malatya, Turkey. alpayt.sezgin@superonline.com
Sigirci
Ahmet
A
Barutcu
Irfan
I
Topal
Ergün
E
Sezgin
Nurzen
N
Ozdemir
Ramazan
R
Yetkin
Ertan
E
Tandogan
Izzet
I
Kosar
Feridun
F
Ermis
Necip
N
Yologlu
Saim
S
Bariskaner
Emrah
E
Cehreli
Sengul
S
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000503:physiopathology; D003326:Coronary Circulation / Q000502:physiology*; D003328:Coronary Thrombosis / Q000188:drug therapy / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000503:physiopathology; D005996:Nitroglycerin / Q000627:therapeutic use; D013223:Statistics as Topic; D014421:Turkey; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents; D005996:Nitroglycerin