Department of Cardiovascular Ultrasound, First Hospital of China Medical University, Shenyang, Liaoning, China.
Department of Cardiology, First Hospital of China Medical University, Shenyang, Liaoning, China.
Cardiol J. 2022;29(4):619-626. doi: 10.5603/CJ.a2020.0027. Epub 2020 Feb 27.
Slow coronary flow (SCF) is an angiographic entity characterized by delayed coronary opacification without an evident obstructive lesion in the epicardial coronary artery. However, patients with SCF have decreased left ventricular (LV) global longitudinal strain (GLS). SCF is associated with inflammation, and soluble endothelial protein C receptor (sEPCR) is a potential biomarker of inflammation. Therefore, under evaluation herein, was the relationship between SCF and sEPCR and the predictive value of sEPCR and LV GLS for SCF was investigated.
Twenty-eight patients with SCF and 34 controls were enrolled. SCF was diagnosed by the thrombolysis in myocardial infarction frame count (TFC). The plasma level of sEPCR was quantified using enzyme-linked immunosorbent assay. LV GLS was measured by two-dimensional speckle-tracking echocardiography.
Plasma sEPCR was significantly higher in patients with SCF than in controls and was positively correlated with the mean TFC (r = 0.67, p < 0.001) and number of involved vessels (r = 0.61, p < 0.001). LV GLS was decreased in patients with SCF compared to that in controls. sEPCR level (OR = 3.14, 95% CI 1.55-6.36, p = 0.001) and LV GLS (OR = 1.44, 95% CI 1.02-2.04, p = 0.04) were independent predictors of SCF. sEPCR predicted SCF (area under curve [AUC]: 0.83); however, sEPCR > 9.63 ng/mL combined with LV GLS > -14.36% demonstrated better predictive power (AUC: 0.89; sensitivity: 75%; specificity: 91%).
Patients with SCF have increased plasma sEPCR and decreased LV GLS. sEPCR may be a useful potential biomarker for SCF, and sEPCR combined with LV GLS can better predict SCF.
缓慢冠状动脉血流（SCF）是一种以冠状动脉造影无明显心外膜冠状动脉阻塞病变但延迟显影为特征的现象。然而，SCF 患者的左心室（LV）整体纵向应变（GLS）降低。SCF 与炎症有关，可溶性内皮蛋白 C 受体（sEPCR）是炎症的潜在生物标志物。因此，在此评估中，研究了 SCF 与 sEPCR 之间的关系，以及 sEPCR 和 LV GLS 对 SCF 的预测价值。
纳入 28 例 SCF 患者和 34 例对照。通过心肌梗死溶栓帧数（TFC）诊断 SCF。使用酶联免疫吸附试验定量测定血浆 sEPCR 水平。通过二维斑点追踪超声心动图测量 LV GLS。
与对照组相比，SCF 患者的血浆 sEPCR 显著升高，与平均 TFC（r = 0.67，p < 0.001）和受累血管数（r = 0.61，p < 0.001）呈正相关。与对照组相比，SCF 患者的 LV GLS 降低。sEPCR 水平（OR = 3.14，95%CI 1.55-6.36，p = 0.001）和 LV GLS（OR = 1.44，95%CI 1.02-2.04，p = 0.04）是 SCF 的独立预测因子。sEPCR 预测 SCF（曲线下面积 [AUC]：0.83）；然而，sEPCR > 9.63ng/mL 结合 LV GLS > -14.36% 具有更好的预测能力（AUC：0.89；灵敏度：75%；特异性：91%）。
SCF 患者的血浆 sEPCR 升高，LV GLS 降低。sEPCR 可能是 SCF 的一种有用的潜在生物标志物，sEPCR 联合 LV GLS 可更好地预测 SCF。
