Dogan Zekeriya, Ileri Cigdem, Ozben Beste, Sunbul Murat, Tigen M Kursat, Sahin Ozlem, Yesildag Osman
Department of Cardiology, Marmara University School of Medicine.
Department of Cardiology, Kosuyolu Heart Education and Research Hospital.
Acta Cardiol Sin. 2023 Sep;39(5):733-741. doi: 10.6515/ACS.202309_39(5).20230209A.
Coronary slow flow may not only affect the coronary arteries, but it may also be a vascular problem affecting the rest of the arterial system.
The aim of this study was to determine peripheral arterial stiffness and the thickness of the choroid layer in patients with slow coronary flow.
Fifty consecutive patients (age, 54.3 ± 11.4 years, 38 male) with coronary slow flow and 25 consecutive patients (age, 50.5 ± 9.9 years, 16 male) with normal coronary arteries both documented by coronary angiography were included. Arterial stiffness parameters were measured noninvasively using a Mobil-O-Graph arteriography system. The choroidal thickness was assessed using the enhanced depth imaging optical coherence tomography method.
The patients with coronary slow flow had significantly higher peripheral systolic blood pressure, peripheral pulse pressure, central pulse pressure, and pulse wave velocity (PWV) and significantly thinner choroidal thickness compared to the controls. Thrombolysis in myocardial infarction frame count was positively correlated with PWV (r: 0.237, p = 0.041) and negatively correlated with choroidal thickness (r: -0.249, p = 0.031). There was also a negative correlation between PWV and mean choroidal thickness (r: -0.565, p < 0.001). Linear regression analysis showed that coronary slow flow was an independent predictor of both PWV and choroidal thickness when adjusted by age and sex.
The acceleration of average peripheral arterial PWV with a thinning of choroidal thickness in patients with coronary slow flow may support the idea that this phenomenon may be a coronary presentation of a systemic microvascular disorder.
冠状动脉血流缓慢不仅可能影响冠状动脉,还可能是影响动脉系统其他部位的血管问题。
本研究旨在确定冠状动脉血流缓慢患者的外周动脉僵硬度和脉络膜层厚度。
纳入50例经冠状动脉造影证实为冠状动脉血流缓慢的连续患者(年龄54.3±11.4岁,男性38例)和25例冠状动脉正常的连续患者(年龄50.5±9.9岁,男性16例)。使用Mobil-O-Graph动脉造影系统无创测量动脉僵硬度参数。采用增强深度成像光学相干断层扫描方法评估脉络膜厚度。
与对照组相比,冠状动脉血流缓慢患者的外周收缩压、外周脉压、中心脉压和脉搏波速度(PWV)显著更高,脉络膜厚度显著更薄。心肌梗死溶栓帧数与PWV呈正相关(r:0.237,p = 0.041),与脉络膜厚度呈负相关(r:-0.249,p = 0.031)。PWV与平均脉络膜厚度之间也呈负相关(r:-0.565,p < 0.001)。线性回归分析表明,在按年龄和性别调整后,冠状动脉血流缓慢是PWV和脉络膜厚度的独立预测因素。
冠状动脉血流缓慢患者平均外周动脉PWV加快且脉络膜厚度变薄,这可能支持以下观点,即这种现象可能是全身性微血管疾病的冠状动脉表现。