Sadr-Ameli Mohammad Ali, Saedi Sedigheh, Saedi Tahereh, Madani Mohsen, Esmaeili Mehrdad, Ghardoost Behshid
Department of Cardiology, Shahid Rajaie Cardiovascular, Medical, Research Center, Iran University of Medical Sciences; Tehran-Iran.
Anatol J Cardiol. 2015 Jul;15(7):531-5. doi: 10.5152/akd.2014.5578. Epub 2014 Jul 11.
Coronary slow flow phenomenon has been arbitrarily defined as delayed coronary blood flow in the absence of obstructive coronary artery disease. The present study sought to investigate the clinical features, natural history, and outcomes of affected patients.
In this prospective cross-sectional study, 217 consecutive patients who had undergone coronary angiography and showed features of coronary slow flow phenomenon were evaluated for demographic and coronary risk factor profile, as well as clinical outcomes, at baseline and following treatment.
The study population consisted of 165 (76%) males and 52 (24%) females. The mean age of patients was 52.6±10 years. Mean ejection fraction was 48.2±5.4, 39.3% had diabetes, 43.3% had hypertension, 49.8% was a cigarette smoker, 41.9% had dyslipidemia, and 15% had a familial history of cardiac disease. Forty-nine percent was detected to have abnormal hsCRP levels. The most prevalent presenting complaint was atypical chest pain. Fifty-four percent of patients had slow blood flow in all three vessels. Thirty-six people had undergone repeat coronary angiography in a follow-up period of 5-7 years due to persisting or worsening clinical symptoms, of whom 6 (16.6%) showed significant coronary artery stenosis. Eight (22.2%) had mild CAD, and the rest still showed coronary slow flow without significant stenosis. The most common complaint during follow-up and after initiation of medical therapy was nonanginal chest pain.
Patients with coronary slow flow phenomenon are predisposed to atherosclerosis and obstructive coronary artery disease. Therefore, this pathology should not be considered as a totally benign condition. Primary and secondary cardiovasculature preventive measures should be constituted and seem worthwhile in this patient population.
冠状动脉慢血流现象被随意定义为在无阻塞性冠状动脉疾病情况下的冠状动脉血流延迟。本研究旨在调查受影响患者的临床特征、自然病史及预后情况。
在这项前瞻性横断面研究中，对217例连续接受冠状动脉造影且表现出冠状动脉慢血流现象特征的患者进行了评估，包括人口统计学和冠状动脉危险因素概况，以及基线和治疗后的临床结局。
研究人群包括165例（76%）男性和52例（24%）女性。患者的平均年龄为52.6±10岁。平均射血分数为48.2±5.4，39.3%患有糖尿病，43.3%患有高血压，49.8%为吸烟者，41.9%患有血脂异常，15%有心脏病家族史。49%的患者检测出血清超敏C反应蛋白（hsCRP）水平异常。最常见的主诉是非典型胸痛。54%的患者三支血管均存在血流缓慢。36人在5至7年的随访期内因临床症状持续或恶化接受了重复冠状动脉造影，其中6例（16.6%）显示有明显冠状动脉狭窄。8例（22.2%）有轻度冠状动脉疾病，其余患者仍表现为冠状动脉慢血流但无明显狭窄。随访期间及开始药物治疗后最常见的主诉是非心绞痛性胸痛。
冠状动脉慢血流现象患者易患动脉粥样硬化和阻塞性冠状动脉疾病。因此，不应将这种病理情况视为完全良性的状况。在这类患者群体中，应制定一级和二级心血管预防措施，且这些措施似乎是值得的。
