Vascular endothelial function in patients with slow... : Coronary Artery Disease (original) (raw)

Pathophysiology and Natural History

Sezgin, Alpay Turana; Sgrc, Ahmetbııı; Barutcu, Irfana; Topal, Ergüna; Sezgin, Nurzenc; Ozdemir, Ramazana; Yetkin, Ertana; Tandogan, Izzeta; Kosar, Feriduna; Ermis, Necipa; Yologlu, Saimd; Barskaner, Emrahaı; Cehreli, Sengula

Departments of aCardiology

bRadiology

cBiochemistry

dBiostatistics, Inonu University, Malatya, Turkey

Correspondence and requests for reprints to Alpay T. Sezgin MD, Department of Cardiology, Faculty of Medicine, Baskent University Adana Uygulama ve Araştırma, 6 Merkezi Dadaloglu Mah. 39 Street, Yuregir/Adana 01250, Turkey.

Tel: +90 322 3272727; fax: +90 322 3271274;

e-mail: [email protected]

Received 8 August 2002 Accepted 20 December 2002

Abstract

Background

Slow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear.

Design

The aim of the study was to determine endothelial function in patients with SCF using a flow-mediated dilatation (FMD) technique in the brachial artery.

Methods

Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count (CTFC) method. Endothelial function was studied in 27 patients with SCF (23 men, four women, mean age 47.6±8.7 years) and in 30 people with normal coronary flow (NCF) (22 men and eight women, mean age 47.5±7.4 years).

Results

The flow-mediated diameter increase in the SCF group was significantly smaller than that in the NCF group (3.48±0.10% compared with 9.11±0.10%, P < 0.001). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and people with NCF (16.8±1.1% compared with 17.1±1.1%, P = 0.87). Simple regression analysis showed that mean CTFC (CTFCm) was strongly and inversely related to the percentage of FMD (r = –0.29, P < 0.01) in all participants. When the patients with SCF were excluded, CTFCm was still inversely related to the percentage of FMD (r = –0.36, P < 0.05). CTFCm was also inversely related to NTG-induced dilatation in the 57 participants (r = –0.23, P < 0.05). Multiple regression analysis showed that CTFCm was inversely related to the percentage of FMD only (r = –0.37, P < 0.05).

Conclusions

These findings suggest that endothelial function is impaired in people with SCF and that CTFC correlates well with endothelial dysfunction.