title: Coronary slow flow phenomenon associated with high serum levels of soluble CD40 ligand and urotensin II: a multi-marker approach.
abstract: BACKGROUND
  The aim of this study was to evaluate the serum soluble CD40 ligand (sCD40L) levels, serum uroten- sin II levels, and serum leptin levels as an indirect indicator of endothelial dysfunction, inflammation, and atherosclerosis at the microvascular level, and the comparison of those values with those of the control group with a nor- mal coronary flow pattern.
  
  
  METHODS
  The study included 35 consecutive patients (17 women, 18 men; average age: 51.20 ± 10.93 years) in our hospital who underwent coronary angiography due to objective myocardial ischemia and in whom slow coronary flow was detected. The control group included 34 consecutive patients with normal coronary flow pattern (18 women, 16 men; average age: 54.59 ± 12.40 years). The coronary flow rates of all patients and control subjects were documented by the thrombolysis in myocardial infarction (TIMI) frame count. Serum sCD40L concentrations, serum urotensin II concentrations and serum leptin concentrations were measured by an enzyme-linked immunosorbent assay method using commercially available kits.
  
  
  RESULTS
  The corrected TIMI frame count for LAD, Cx, RCA, and mean TIMI frame count were significantly higher in patients with slow coronary flow (SCF), compared to subjects with normal coronary flow (43.8 ± 1.7 vs. 17.7 ± 4.7, p < 0.001; 27.9 ± 6.9 vs. 11.9 ± 4.8, p < 0.001; 25.4 ± 8.4 vs. 11.1 ± 3.1, p < 0.001; and 32.3 ± 6.4 vs. 13.7 ± 5, p < 0.001, respectively). The serum soluble CD40 ligand and serum urotensin II levels were significantly higher in the slow coronary flow group compared to the control group (12.00 ± 5.43 ng/mL--6.49 ± 5.03 ng/mL, p < 0.001; and 50.94 ± 34.28 pg/mL--26.91 ± 11.52 pg/mL, p < 0.001, respectively). In addition, there was no statistically significant difference between the slow coronary flow group and the control group with regard to serum leptin levels and hs-CRP levels (both p > 0.05).
  
  
  CONCLUSIONS
  This study suggests that soluble CD40 ligand and urotensin II likely play a role in the pathogenesis of slow coronary flow.
authors: Bulent
authors: B
authors: Demir
authors: Ilker Murat
authors: IM
authors: Caglar
authors: Hande Oktay
authors: HO
authors: Tureli
authors: Osman
authors: O
authors: Pirhan
authors: Gonul
authors: G
authors: Aciksari
authors: Serkan Çifçi
authors: Cem Özde
authors: Asuman
authors: A
authors: Gedikbasi
authors: Cafer
authors: C
authors: Zorkun
authors: Esra
authors: E
authors: Demir
authors: Osman
authors: O
authors: Karakaya
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood*; D016022:Case-Control Studies; D017023:Coronary Angiography; D003326:Coronary Circulation; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D043562:Receptors, G-Protein-Coupled / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D020738:Leptin; D043562:Receptors, G-Protein-Coupled; C121697:UTS2R protein, human; D023201:CD40 Ligand