Zhang Xiaobing, Ding Jiandong, Xia Siliang
Cardiology Department, Nanjing Jiangbei People's Hospital, Nanjing, China.
Cardiology Department, Zhongda Hospital, Southeast University, Nanjing, China.
Ann Palliat Med. 2021 Jan;10(1):657-663. doi: 10.21037/apm-20-2271.
To explore the relationship between coronary slow flow (CSF) and both matrix metalloproteinase-9 (MMP-9) and soluble cluster of differentiation 40 ligand (sCD40L).
Between July 2016 and September 2019, 80 patients suspected of having coronary heart disease due to chest tightness or other symptoms of chest pain and discomfort were admitted to Nanjing Jiangbei People's Hospital and, following a coronary angiography, were diagnosed as having CSF. These patients were assigned to the coronary slow flow phenomenon (CSFP) group. The control group, or normal coronary flow (NCF) group, consisted of 80 patients with normal coronary angiography results. Following group assignment, enzyme-linked immunosorbent assays (ELISAs) were used to measure and compare the serum levels of sCD40L and MMP-9 between the two groups.
Serum levels of sCD40L and MMP-9 in the CSFP group were significantly higher than those in the NCF group (PP<0.05). Additionally, serum levels of adhesion molecules and C-reactive protein (CRP) in the CSFP group were significantly higher than those in NCF group (P<0.05). There was a positive correlation observed between sCD40L levels and adhesion molecule levels in the CSFP group, however, there was no such correlation observed in the NCF group. The CSFP group also had a significantly higher corrected TIMI frame count (CTFC) compared with the NCF group (PP<0.05).
Serum MMP-9 levels were higher in patients with CSF, and MMP-9 levels were positively correlated with CTFC. This suggests that chronic inflammation may play a role in CSF pathogenesis and that atherosclerotic plaques may be present in the coronary arteries of CSF patients. Additionally, serum levels of sCD40L, adhesion molecules, and CRP were higher in CSF patients, and CRP levels were positively correlated with CTFC. Adhesion molecule expression is promoted by sCD40L. Increased levels of sCD40L may therefore promote the development of CSF.
探讨冠状动脉慢血流（CSF）与基质金属蛋白酶-9（MMP-9）及可溶性分化簇40配体（sCD40L）之间的关系。
2016年7月至2019年9月，80例因胸闷或其他胸痛不适症状疑似患有冠心病的患者入住南京江北人民医院，经冠状动脉造影后被诊断为CSF。这些患者被分配到冠状动脉慢血流现象（CSFP）组。对照组，即正常冠状动脉血流（NCF）组，由80例冠状动脉造影结果正常的患者组成。分组后，采用酶联免疫吸附测定（ELISA）法测量并比较两组患者血清中sCD40L和MMP-9的水平。
CSFP组血清sCD40L和MMP-9水平显著高于NCF组（P<0.05）。此外，CSFP组血清黏附分子和C反应蛋白（CRP）水平显著高于NCF组（P<0.05）。CSFP组中sCD40L水平与黏附分子水平呈正相关，而NCF组未观察到这种相关性。与NCF组相比，CSFP组校正的心肌梗死溶栓治疗（TIMI）帧数（CTFC）也显著更高（P<0.05）。
CSF患者血清MMP-9水平较高，且MMP-9水平与CTFC呈正相关。这表明慢性炎症可能在CSF发病机制中起作用，且CSF患者冠状动脉中可能存在动脉粥样硬化斑块。此外，CSF患者血清sCD40L、黏附分子和CRP水平较高，且CRP水平与CTFC呈正相关。sCD40L可促进黏附分子表达。因此，sCD40L水平升高可能促进CSF的发展。
