Lack of correlation between coronary blood flow and carotid intima media thickness.
BACKGROUND
The phenomenon of slow coronary flow (SCF) in the presence of normal coronary arteries may indicate endothelial dysfunction, which is characteristic of an early stage in the development of atherosclerosis. Measurement of the Carotid Intima-Media Thickness (CIMT) allows identification of early stages of atherosclerosis. CIMT might offer a non-invasive method of diagnosing SCF patients. Previous studies demonstrated conflicting results regarding the relationship between these two phenomena. In the present study, we examined the association between coronary flow velocity and the degree of CIMT in patients with angiographically normal coronary arteries.


METHODS
Coronary arterial blood flow velocity was measured using two methods - Corrected Thrombolysis in Myocardial Infarction (TIMI) Frame Count (CTFC) and Coronary Clearance Frame Count (CCFC). In addition, we measured the level of the CIMT using a special automated computerized software.


RESULTS
Seventy Five consecutive patients were prospectively recruited. No correlation was found between CIMT and mean CTFC (r = -0.08, p = NS) or mean CCFC (r = -0.07, p = NS). In addition, CIMT values did not differ between the SCF and the Normal coronary flow (NCF) groups (0.796 mm vs. 0.805 mm, respectively, p = 0.733). Patients with SCF had higher levels of hematocrit (39.9% vs. 36.1%, p < 0.001), LDL cholesterol (101.1 mg/dl vs. 85.8 mg/dl, p = 0.01) and higher rate of current smokers (28.9% vs. 10.8%, p = 0.05).


CONCLUSIONS
Patients with angiographically normal coronary arteries and SCF do not have increased CIMT values. However, current smoking, higher LDL cholesterol and hematocrit levels are all related to slower coronary blood flow.
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Yaron
Y
Arbel
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Yishay
Y
Szekely
Internal Medicine "D" and "E", Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Shlomo
S
Berliner
Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Hen
H
Hallevi
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Amir
A
Halkin
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Itzhak
I
Herz
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gad
G
Keren
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Shmuel
S
Bazan
Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Natan
N
Bornstein
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Shmuel
S
Banai
Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ariel
A
Finkelstein
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000473:pathology; D001783:Blood Flow Velocity; D002318:Cardiovascular Diseases / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
Normal coronary arteries; TIMI frame count; carotid intima-media thickness; coronary flow; slow flow; smoking