Departments of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Internal Medicine "D" and "E", Tel Aviv Sourasky Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Clin Hemorheol Microcirc. 2014;56(4):371-81. doi: 10.3233/CH-141808.
The phenomenon of slow coronary flow (SCF) in the presence of normal coronary arteries may indicate endothelial dysfunction, which is characteristic of an early stage in the development of atherosclerosis. Measurement of the Carotid Intima-Media Thickness (CIMT) allows identification of early stages of atherosclerosis. CIMT might offer a non-invasive method of diagnosing SCF patients. Previous studies demonstrated conflicting results regarding the relationship between these two phenomena. In the present study, we examined the association between coronary flow velocity and the degree of CIMT in patients with angiographically normal coronary arteries.
Coronary arterial blood flow velocity was measured using two methods - Corrected Thrombolysis in Myocardial Infarction (TIMI) Frame Count (CTFC) and Coronary Clearance Frame Count (CCFC). In addition, we measured the level of the CIMT using a special automated computerized software.
Seventy Five consecutive patients were prospectively recruited. No correlation was found between CIMT and mean CTFC (r = -0.08, p = NS) or mean CCFC (r = -0.07, p = NS). In addition, CIMT values did not differ between the SCF and the Normal coronary flow (NCF) groups (0.796 mm vs. 0.805 mm, respectively, p = 0.733). Patients with SCF had higher levels of hematocrit (39.9% vs. 36.1%, p < 0.001), LDL cholesterol (101.1 mg/dl vs. 85.8 mg/dl, p = 0.01) and higher rate of current smokers (28.9% vs. 10.8%, p = 0.05).
Patients with angiographically normal coronary arteries and SCF do not have increased CIMT values. However, current smoking, higher LDL cholesterol and hematocrit levels are all related to slower coronary blood flow.
在正常冠状动脉存在的情况下，出现的缓慢冠状动脉血流（SCF）现象可能表明内皮功能障碍，这是动脉粥样硬化发展早期的特征。颈动脉内膜中层厚度（CIMT）的测量可识别动脉粥样硬化的早期阶段。CIMT 可能为诊断 SCF 患者提供一种非侵入性方法。先前的研究表明，这两种现象之间的关系存在相互矛盾的结果。在本研究中，我们检查了在血管造影正常的冠状动脉患者中，冠状动脉血流速度与 CIMT 程度之间的关系。
使用两种方法测量冠状动脉血流速度 - 校正的心肌梗死溶栓（TIMI）帧数计数（CTFC）和冠状动脉清除帧数计数（CCFC）。此外，我们使用特殊的自动化计算机软件测量 CIMT 水平。
75 例连续患者被前瞻性招募。CIMT 与平均 CTFC（r = -0.08，p = NS）或平均 CCFC（r = -0.07，p = NS）之间没有相关性。此外，SCF 组和正常冠状动脉血流（NCF）组的 CIMT 值没有差异（分别为 0.796mm 和 0.805mm，p = 0.733）。SCF 患者的红细胞压积（39.9% vs. 36.1%，p <0.001），LDL 胆固醇（101.1mg/dl vs. 85.8mg/dl，p = 0.01）和当前吸烟者的比例（28.9% vs. 10.8%，p = 0.05）更高。
血管造影正常的冠状动脉和 SCF 患者的 CIMT 值没有增加。然而，当前吸烟，更高的 LDL 胆固醇和红细胞压积水平均与较慢的冠状动脉血流有关。
