title: Inverse correlation between coronary and retinal blood flows in patients with normal coronary arteries and slow coronary blood flow.
abstract: BACKGROUND
  The "Slow Coronary Flow" (SCF) phenomenon in the presence of angiographically normal coronaries is attributed to microvascular and endothelial dysfunction. The microcirculation can be non-invasively assessed by measuring retinal blood flow velocity. The aim of the present study was to evaluate the efficacy of the "Retinal Functional Imager" (RFI) device as a noninvasive method of diagnosing patients with slow coronary flow.
  
  
  METHODS
  Coronary blood flow velocity assessed by corrected TIMI Frame Count and retinal arterioles blood flow assessed by RFI were measured in 28 consecutive patients with normal coronary arteries. The patients were divided into 2 groups: a slow coronary flow (SCF) and a normal coronary flow (NCF) groups.
  
  
  RESULTS
  Inverse correlation was found between retinal and coronary blood flows so that higher retinal arterial flow velocity was observed in the SCF group (3.8 ± 1.1 mm/s vs. 2.9 ± 0.61 mm/s, respectively, p = 0.022). RFI provided 73% sensitivity and 77% specificity for diagnosing SCF using ROC analysis. Additionally, patients with SCF had higher values of serum LDL cholesterol (104.7 ± 18.93 mg/dl vs. 81.55 ± 14.62 mg/dl in NCF, p = 0.005), Glucose (96.9 ± 23.0 mg/dl vs. 83.55 ± 9.7 mg/dl in NCF, p = 0.024), and lower percentage of statin consumption (40.0% vs. 76.9% in NCF, p = 0.049).
  
  
  CONCLUSIONS
  Slow coronary blood flow can be non-invasively diagnosed with Retinal Functional Imager. Patients with normal coronary arteries and slow coronary blood flow have high retinal arteriolar blood flow. Early non-invasive diagnosis of SCF might help detect individuals who are at higher risk to develop coronary atherosclerosis, and to provide them with early preventive measures.
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: yarona@tlvmc.gov.il.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Arbel
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Sternfeld
authors.affiliation: Department of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Adiel
authors.initials: A
authors.lastname: Barak
authors.affiliation: Department of Ophthalmology, The Edith Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Zvia
authors.initials: Z
authors.lastname: Burgansky-Eliash
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.affiliation: Department of Internal Medicine "D" and "E", Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Herz
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.affiliation: Department of Metabolic Clinic, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ardon
authors.initials: A
authors.lastname: Rubinstein
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Banai
authors.affiliation: Department of Cardiology, Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Finkelstein
mesh_terms: D000328:Adult; D000368:Aged; D001160:Arterioles / Q000503:physiopathology; D001783:Blood Flow Velocity; D002637:Chest Pain; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000503:physiopathology*; D011446:Prospective Studies; D012372:ROC Curve; D012160:Retina / Q000503:physiopathology*; D012171:Retinal Vessels / Q000473:pathology*; D012307:Risk Factors
keywords: Coronary flow; Normal coronary arteries; Retinal blood flow; Slow coronary flow; TIMI frame count