title: Nicorandil improves myocardial function by regulating plasma nitric oxide and endothelin-1 in coronary slow flow.
abstract: BACKGROUND
  Coronary slow flow (CSF) is a special coronary microvascular disorder. The pathogenesis and effective therapeutics of CSF remain unclear. This study aimed to evaluate the global and regional functions of the left ventricle (LV) and investigate the efficacy of nicorandil in patients with CSF.
  
  
  METHODS
  Thirty-six patients with CSF in the left anterior descending (LAD) branch and 20 patients with normal coronary arteries were included. Global and regional functions of the LV supplied by LAD were measured using conventional Doppler echocardiography and two-dimensional speckle tracking echocardiography, respectively, within 24 h after coronary angiography. Concentrations of plasma nitric oxide (NO) and endothelin-1 (ET-1) were detected using colorimetry and radioimmunoassay, respectively. The function of the LV and the levels of NO and ET-1 were also investigated before and 90 days after treatment with 15 mg/day of nicorandil.
  
  
  RESULTS
  Compared with the control group, the early diastolic peak velocity (E), E/A ratio, and plasma NO levels were lower, whereas the late diastolic peak flow velocity (A) and plasma ET-1 levels were significantly higher in the CSF group (P<0.05). The longitudinal strain rate peak of the LV was reduced significantly in CSF patients (P<0.001). After treatment, 75% (27/36) of CSF patients were free of chest pain. The values of E peak, E/A ratio, longitudinal strain rate peak, and plasma NO level were increased (P<0.001), whereas the ET-1 level was decreased in CSF patients (P<0.001).
  
  
  CONCLUSIONS
  Nicorandil may improve chest pain symptoms and the impaired function of the LV, possibly by increasing plasma NO and reducing ET-1 in CSF.
authors.affiliation: Departments of aCardiology bCardiac Ultrasound, The Affiliated Hospital of Qingdao University cDepartment of Internal Medicine, Qingdao Commercial Hospital dDepartment of Cardiology, Qingdao Fifth People's Hospital, Qingdao eDepartment of Cardiology, Dezhou People's Hospital, Dezhou, Shandong, China.
authors.forename: Zuoyuan
authors.initials: Z
authors.lastname: Chen
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Chen
authors.forename: Shan
authors.initials: S
authors.lastname: Li
authors.forename: Xuezhen
authors.initials: X
authors.lastname: Huo
authors.forename: Xiuxiu
authors.initials: X
authors.lastname: Fu
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Dong
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D003124:Colorimetry; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020108:Nicorandil / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000097:blood*; D054318:No-Reflow Phenomenon / Q000188:drug therapy* / Q000503:physiopathology; D011863:Radioimmunoassay
chemical_list: D000889:Anti-Arrhythmia Agents; D019332:Endothelin-1; D020108:Nicorandil; D009569:Nitric Oxide