Hussein Osamah, Zidan Jamal, Plich Michael, Gefen Hana, Klein Roberto, Shestatski Karina, Abu-Jabal Kamal, Zimlichman Reuven
Department of Internal Medicine A, Ziv Medical Center, Safed, Israel.
Bar-Ilan Faculty of Medicine, Safed, Israel.
Isr Med Assoc J. 2013 Dec;15(12):753-7.
Coronary slow flow phenomenon (CSFP) is a functional and structural disease that is diagnosed by coronary angiogram.
To evaluate the possible association between CSFP and small artery elasticity in an effort to understand the pathogenesis of CSFP.
The study population comprised 12 patients with normal coronary arteries and CSFP and 12 with normal coronary arteries without CSFP. We measured conjugated diene formation at 234 nm during low density lipoprotein (LDL) oxidation, as well as platelet aggregation. We estimated, noninvasively, arterial elasticity parameters. Mann-Whitney nonparametric test was used to compare differences between the groups. Data are presented as mean +/- standard deviation.
Waist circumference was 99.2 +/- 8.8 cm and 114.9 +/- 10.5 cm in the normal flow and CSFP groups, respectively (P = 0.003). Four patients in the CSFP group and one in the normal flow group had type 2 diabetes. Area under the curve in the oral glucose tolerance test was 22% higher in the CSFP than in the normal group (P = 0.04). There was no difference in systolic and diastolic blood pressure, plasma concentrations of total cholesterol, triglycerides, high density lipoprotein, LDL and platelet aggregation parameters between the groups. Lag time required until initiation of LDL oxidation in the presence of CuSO4 was 17% longer (P = 0.02) and homocysteine fasting plasma concentration was 81% lower (P = 0.05) in the normal flow group. Large artery elasticity was the same in both groups. Small artery elasticity was 5 +/- 1.5 ml/mmHg x 100 in normal flow subjects and 6.1 +/- 1.9 ml/mmHg x 100 in the CSFP patients (P = 0.02).
Patients with CSFP had more metabolic derangements. Arterial stiffness was not increased in CSFP.
冠状动脉血流缓慢现象（CSFP）是一种通过冠状动脉血管造影诊断的功能性和结构性疾病。
评估CSFP与小动脉弹性之间的可能关联，以了解CSFP的发病机制。
研究人群包括12例冠状动脉正常且有CSFP的患者和12例冠状动脉正常且无CSFP的患者。我们测量了低密度脂蛋白（LDL）氧化过程中234nm处共轭二烯的形成以及血小板聚集情况。我们采用非侵入性方法估算动脉弹性参数。使用曼-惠特尼非参数检验比较两组之间的差异。数据以平均值±标准差表示。
正常血流组和CSFP组的腰围分别为99.2±8.8cm和114.9±10.5cm（P = 0.003）。CSFP组有4例患者，正常血流组有1例患者患有2型糖尿病。口服葡萄糖耐量试验的曲线下面积，CSFP组比正常组高22%（P = 0.04）。两组之间的收缩压和舒张压、血浆总胆固醇、甘油三酯、高密度脂蛋白浓度、LDL以及血小板聚集参数均无差异。在硫酸铜存在的情况下，正常血流组开始LDL氧化所需的延迟时间长17%（P = 0.02），空腹血浆同型半胱氨酸浓度低81%（P = 0.05）。两组的大动脉弹性相同。正常血流受试者的小动脉弹性为5±1.5ml/mmHg×100，CSFP患者为6.1±1.9ml/mmHg×100（P = 0.02）。
CSFP患者有更多的代谢紊乱。CSFP患者的动脉僵硬度并未增加。
