title: The association between coronary flow rate and impaired heart rate recovery in patients with metabolic syndrome: A preliminary report.
abstract: BACKGROUND
  The aim of this study is to evaluate heart rate recovery (HRR) and association between coronary flow rate and HRR in patients with metabolic syndrome (MS) who had morphologically normal coronary angiogram.
  
  
  METHODS
  Study population included 43 patients with MS and 37 control subjects without MS. All patients were selected from individuals who had recently undergone coronary angiography in our hospital and were diagnosed as having angiographically normal coronary arteries. Exercise stress test results obtained prior to coronary angiography were evaluated for calculating HRR and other parameters. In addition, coronary flow was objectively evaluated for each major coronary artery in each subject using TIMI frame count method.
  
  
  RESULTS
  All HRR values calculated were detected significantly lower in MS group compared to controls (HRR first: 32 ± 9 vs. 37 ± 10; p = 0.01, second: 46 ± 11 vs. 52 ± 11; p = 0.03, third: 51 ± 12 vs. 59 ± 12; p = 0.00, fourth: 54 ± 13 vs. 61 ± 2; p = 0.02). TIMI frame counts for each major epicardial coronary artery and mean TIMI frame count were also found to be significantly higher in MS group compared to controls (left anterior descending artery:51 ± 24 vs. 39 ± 15; p = 0.009, left circumflex artery: 32 ± 11 vs. 24 ± 7; p = 0.001, right coronary artery: 33 ± 14 vs. 24 ± 10; p = 0.003, mean TIMI frame count: 38 ± 15 vs. 29 ± 9;p = 0.002). Additionally, significant negative correlations were also detected between HRR first minute and coronary TIMI frame count values in patients with MS. None of MS parameters did not affect HRR values, however mean TIMI frame count independently associated with HRR first minute (p = 0.04) in patients with MS.
  
  
  CONCLUSIONS
  Impaired coronary blood flow occurring in MS might be a clue of autonomic dysfunction in addition to previously known endothelial dysfunction.
authors.affiliation: Department of Cardiology, Pamukkale University School of Medicine, Denizli, Turkey. aliizyu@mynet.com.
authors.forename: Yusuf I
authors.initials: YI
authors.lastname: Alihanoglu
authors.forename: I Dogu
authors.initials: ID
authors.lastname: Kilic
authors.forename: Harun
authors.initials: H
authors.lastname: Evrengul
authors.forename: Bekir S
authors.initials: BS
authors.lastname: Yildiz
authors.forename: Ihsan
authors.initials: I
authors.lastname: Alur
authors.forename: Burcu
authors.initials: B
authors.lastname: Uludag
authors.forename: Omur
authors.initials: O
authors.lastname: Kuru
authors.forename: Ozgur
authors.initials: O
authors.lastname: Taskoylu
authors.forename: Havane Asuman
authors.initials: HA
authors.lastname: Kaftan
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D008875:Middle Aged; D020127:Recovery of Function