title: Anatomic properties of coronary arteries are correlated to the corrected thrombolysis in myocardial infarction frame count in the coronary slow flow phenomenon.
abstract: BACKGROUND
  Coronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity, but its etiology remains unclear. The purpose of this study was to explore the potential role of local coronary anatomic properties in the genesis of CSFP.
  
  
  METHODS
  One hundred and thirty-one consecutive patients with CSFP and 131 patients with angiographically normal coronary flow were prospectively enrolled after documenting coronary flow by corrected thrombolysis in myocardial infarction frame count (CTFC). Local anatomic parameters including the tortuosity index (TI), the ostial-to-middle diameter ratio, the ostial-to-middle cross-sectional area ratio, and the number of distal branches (NDB) of arteries at end-systole were compared between patients with CSFP and controls.
  
  
  RESULTS
  For each major coronary artery, CSFP patients had higher TI and NBD compared with controls (all P<0.05). The diameter ratio and cross-sectional area ratio of the three major coronary arteries were higher in the CSFP group (P=0.004 and 0.020, respectively). The TI (r=0.476, P<0.001) and NDB (r=0.186, P=0.004) were significantly correlated with CTFC. However, the higher TI (β=0.424, P<0.001) was the only independent correlate to CTFC. Multivariate logistic analysis revealed that TI (adjusted odds ratio 1.17, 95% confidence interval 1.11-1.23, P<0.001) and NDB (adjusted odds ratio 2.20, 95% confidence interval 1.50-3.21, P<0.001) were independent predictors of CSFP.
  
  
  CONCLUSIONS
  The presence of CSFP was associated with higher tortuosity and more distal branches in coronary arteries, indicating that the anatomic properties of coronary arteries could also play a role in the pathogenesis of CSFP.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Shao-Ping
authors.initials: SP
authors.lastname: Nie
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Geng
authors.forename: Bai-Qiu
authors.initials: BQ
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Qiao
authors.forename: Xin-Min
authors.initials: XM
authors.lastname: Liu
authors.forename: Tai-Yang
authors.initials: TY
authors.lastname: Luo
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Liu
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D054318:No-Reflow Phenomenon / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D015912:Thrombolytic Therapy