Cakmak Mahmut, Tanriverdi Halil, Cakmak Nazmiye, Evrengul Harun, Cetemen Sebnem, Kuru Omur
Department of Cardiology, Siyami Ersek Cardiac and Thoracic Surgery Center, Istanbul, Turkey.
Cardiology. 2008;110(1):39-44. doi: 10.1159/000109405. Epub 2007 Oct 10.
The slow coronary flow (SCF) phenomenon is a coronary microvascular disorder characterized by the delayed passage of contrast in the absence of obstructive epicardial coronary disease. Recent studies showed the possible role of endothelial dysfunction, diffuse atherosclerosis and inflammation in the pathogenesis of this phenomenon. We aimed to investigate the effect of statin on myocardial perfusion in patients with SCF.
The study population consisted of 97 patients with SCF. Coronary flow patterns of the cases are determined by thrombolysis in myocardial infarction (TIMI) frame count method. Single-photon emission computed tomographic myocardial perfusion imaging studies and lipid parameters of the patients were obtained before and after 6 months of simvastatin treatment period. During the study, daily single dose of 40 mg simvastatin has been given to each subject. We found a significant positive correlation between mean TIMI frame count and basal reversibility score (r = 0.84, p = 0.0001). In addition, analysis of the reversibility scores demonstrates that simvastatin treatment has significantly improved the myocardial perfusion abnormality at the end of the follow-up period.
Present findings allow us to conclude that simvastatin improved myocardial perfusion in patients with SCF.
冠状动脉血流缓慢(SCF)现象是一种冠状动脉微血管疾病,其特征是在无阻塞性心外膜冠状动脉疾病的情况下造影剂通过延迟。最近的研究表明内皮功能障碍、弥漫性动脉粥样硬化和炎症在该现象的发病机制中可能起作用。我们旨在研究他汀类药物对SCF患者心肌灌注的影响。
研究人群包括97例SCF患者。采用心肌梗死溶栓(TIMI)帧数法确定病例的冠状动脉血流模式。在辛伐他汀治疗6个月前后,获取患者的单光子发射计算机断层扫描心肌灌注成像研究和血脂参数。在研究期间,给每个受试者每日单剂量40mg辛伐他汀。我们发现平均TIMI帧数与基础可逆性评分之间存在显著正相关(r = 0.84,p = 0.0001)。此外,可逆性评分分析表明,辛伐他汀治疗在随访期末显著改善了心肌灌注异常。
目前的研究结果使我们得出结论,辛伐他汀改善了SCF患者的心肌灌注。