Shirani Shapour, Darabian Sirous, Jozaghi Solmaz, Hamidian Reza
Tehran Heart Centre Hospital, Medical Sciences/University of Tehran, Tehran, Iran.
Cardiol J. 2009;16(2):146-50.
Slow coronary flow (SCF) is slow dye progression in the coronary arteries during selective angiography, but there is no such study about greater visceral vessels. Studies have suggested that flow-mediated dilation (FMD) is impaired in SCF. Endothelial function can be assessed by FMD in the brachial artery as ischemia-induced vasodilation. Since inflammation is an underlying pathology in the inflammation of visceral vessels and probably SCF, we studied the correlation of aortic ectasia and SCF by means of FMD.
Patients with normal coronary arteries and SCF formed the case group, and patients with normal coronary arteries and normal coronary flow formed the control group. We measured the diameter of the patients' brachial artery at rest, after inflation of a sphygmomanometer on the forearm [endothelial-dependent vasodilation (EDV)], and after use of sublingual nitrate (endothelial-independent vasodilation) by sonography. We also measured the diameter of the aorta using sonography before administration of sublingual nitrate. Endothelial dysfunction was defined as EDV significantly less than standard EDV.
There were insignificant differences between age, gender, and frequency of cardiac risk factors within the case and control groups, but diabetes mellitus was significantly different between the two groups. The diameter of the aorta was insignificantly different between the case and control groups. The response of the brachial artery to the cuff test and sublingual nitrate were insignificantly different between the case and control groups. Endothelial dysfunction based on cuff test and sublingual nitrate administration was significantly more common in men than women, as the p values for cuff and sublingual nitrate were 0.033 and 0.051, respectively.
It seems that there is no correlation between SCFP and aortic ectasia.
冠状动脉血流缓慢(SCF)是指在选择性血管造影期间冠状动脉内造影剂进展缓慢,但关于较大内脏血管尚无此类研究。研究表明,冠状动脉血流缓慢患者的血流介导的血管舒张(FMD)受损。肱动脉的血流介导的血管舒张可作为缺血诱导的血管舒张来评估内皮功能。由于炎症是内脏血管炎症以及可能的冠状动脉血流缓慢的潜在病理机制,我们通过血流介导的血管舒张研究了主动脉扩张与冠状动脉血流缓慢之间的相关性。
冠状动脉正常且存在冠状动脉血流缓慢的患者组成病例组,冠状动脉正常且冠状动脉血流正常的患者组成对照组。我们通过超声检查测量了患者静息时、在前臂使用血压计充气后(内皮依赖性血管舒张[EDV])以及使用舌下硝酸酯后(非内皮依赖性血管舒张)肱动脉的直径。我们还在给予舌下硝酸酯之前通过超声检查测量了主动脉的直径。内皮功能障碍定义为内皮依赖性血管舒张明显小于标准内皮依赖性血管舒张。
病例组和对照组在年龄、性别和心脏危险因素频率方面无显著差异,但两组之间糖尿病存在显著差异。病例组和对照组之间主动脉直径无显著差异。病例组和对照组之间肱动脉对袖带试验和舌下硝酸酯的反应无显著差异。基于袖带试验和舌下硝酸酯给药的内皮功能障碍在男性中比女性更常见,因为袖带试验和舌下硝酸酯的p值分别为0.033和0.051。
冠状动脉血流缓慢与主动脉扩张之间似乎没有相关性。