The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
J Korean Med Sci. 2012 Jun;27(6):614-8. doi: 10.3346/jkms.2012.27.6.614. Epub 2012 May 26.
Flow mediated brachial dilatation (FMD) and carotid intima-media thickness (IMT) have been a surrogate for early atherosclerosis. Slow coronary flow in a normal coronary angiogram is not a rare condition, but its pathogenesis remains unclear. A total of 85 patients with angina were evaluated of their brachial artery FMD, carotid IMT and conventional coronary angiography. Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count method. Group I was a control with normal coronary angiography (n = 41, 56.1 ± 8.0 yr) and group II was no significant coronary stenosis with slow flow (n = 44, 56.3 ± 10.0 yr). Diabetes was rare but dyslipidemia and family history were frequent in group II. Heart rate was higher in group II than in group I. White blood cells, especially monocytes and homocysteine were higher in group II. The FMD was significantly lower in group II than in group I. Elevated heart rate, dyslipidemia and low FMD were independently related with slow coronary flow in regression analysis. Therefore, endothelial dysfunction may be an earlier vascular phenomenon than increased carotid IMT in the patients with slow coronary flow.
血流介导的肱动脉扩张（FMD）和颈动脉内膜中层厚度（IMT）已成为早期动脉粥样硬化的替代指标。正常冠状动脉造影中的慢血流并不是一种罕见情况，但其发病机制尚不清楚。共有 85 名心绞痛患者接受了肱动脉 FMD、颈动脉 IMT 和常规冠状动脉造影评估。使用校正的心肌梗死血栓形成（TIMI）帧数法对冠状动脉血流进行定量。I 组为正常冠状动脉造影（n = 41，56.1 ± 8.0 岁）的对照组，II 组为无明显冠状动脉狭窄伴慢血流（n = 44，56.3 ± 10.0 岁）。糖尿病很少见，但血脂异常和家族史在 II 组中很常见。II 组的心率高于 I 组。白细胞，尤其是单核细胞和同型半胱氨酸在 II 组中较高。FMD 在 II 组明显低于 I 组。回归分析显示，心率升高、血脂异常和 FMD 降低与慢血流独立相关。因此，在慢血流患者中，内皮功能障碍可能是比颈动脉 IMT 增加更早的血管现象。
