Sucato V, Evola S, Quagliana A, Novo G, Andolina G, Assennato P, Novo S
Division of Cardiology, Biomedical Department of Internal Medicine and Specialties (DiBiMIS), Paolo Giaccone Hospital, University of Palermo, Palermo, Italy.
Eur Rev Med Pharmacol Sci. 2014;18(23):3687-9.
Stable microvascular angina (SMVA) describes patients with angina, findings compatible with myocardial ischemia and normal coronary angiograms. The aim of this study was to evaluate the impact of diabetes on the coronary microcirculation troughs angiography indexes (TIMI Frame Count, Myocardial Blush Grade, Total Myocardial Blush Score) and a new index: Total TIMI Frame Count (TTFC).
The study population included 310 patients with SMVA that we split into two populations: diabetic-non hypertensive (164 patients) and non-diabetic-hypertensive (146 patients). We calculated, on angiographic images of each patient, TIMI Frame Count (TFC), Myocardial Blush Grade (MBG) and Total Myocardial Blush Score (TMBS) using the protocol described by Gibson and Yusuf. On the basis of Yusuf's experience we imagined a new index: TTFC like sum of the three coronary TFC.
We found a worse coronary microcirculation in diabetic-non hypertensive patients with lower values of TFC, MBG and TMBS (p = 0.02), compared with non-diabetic hypertensive. New index TTFC is usually higher in diabetics-non hypertensive than non-diabetic hypertensive patients. Patients with positive scintigraphy had a worse TMBS than patients with a negative one, with a high statistical significance (p = 0.003).
Analysis of diabetic non hypertensive and non-diabetic and hypertensive patients with cardiac syndrome X has led to asses that the diabetic population has a greater involvement of microcirculation. Also the new index, TTFC, proved to be a good marker, in agreement with results of other indexes.
稳定型微血管性心绞痛（SMVA）指的是患有心绞痛、有与心肌缺血相符的检查结果且冠状动脉造影正常的患者。本研究的目的是通过血管造影指标（心肌梗死溶栓治疗（TIMI）帧数、心肌 blush 分级、总心肌 blush 评分）以及一项新指标：总 TIMI 帧数（TTFC）来评估糖尿病对冠状动脉微循环的影响。
研究人群包括 310 例 SMVA 患者，我们将其分为两组：糖尿病非高血压组（164 例患者）和非糖尿病高血压组（146 例患者）。我们根据 Gibson 和 Yusuf 描述的方案，在每位患者的血管造影图像上计算 TIMI 帧数（TFC）、心肌 blush 分级（MBG）和总心肌 blush 评分（TMBS）。基于 Yusuf 的经验，我们设想了一项新指标：TTFC，即三根冠状动脉 TFC 的总和。
我们发现，与非糖尿病高血压患者相比，糖尿病非高血压患者的冠状动脉微循环更差，TFC、MBG 和 TMBS 的值更低（p = 0.02）。糖尿病非高血压患者的新指标 TTFC 通常高于非糖尿病高血压患者。心肌闪烁显像阳性的患者 TMBS 比阴性患者更差，具有高度统计学意义（p = 0.003）。
对患有心脏综合征 X 的糖尿病非高血压患者以及非糖尿病高血压患者的分析表明，糖尿病患者的微循环受累程度更大。此外，新指标 TTFC 被证明是一个良好的标志物，与其他指标的结果一致。
