scholarly journals GW26-e2247 Analysis of the clinical characteristics and the characteristics of coronary artery diameter of patients with slow coronary flow

2015 ◽  
Vol 66 (16) ◽  
pp. C143-C144
Author(s):  
Shuliang Zhang ◽  
Jungang Zhang ◽  
Zengrui Lun ◽  
Jian Wang ◽  
Aiyuan Zhang
Keyword(s):  
Coronary Artery ◽  
Coronary Flow ◽  
Clinical Characteristics ◽  
Slow Coronary Flow ◽  
Coronary Artery Diameter

scholarly journals The human coronary vasodilatory response to acute mental stress is mediated by neuronal nitric oxide synthase

2017 ◽  
Vol 313 (3) ◽  
pp. H578-H583 ◽  
Author(s):  
Sitara G. Khan ◽  
Narbeh Melikian ◽  
Husain Shabeeh ◽  
Ana R. Cabaco ◽  
Katherine Martin ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Coronary Artery ◽  
Nitric Oxide Synthase ◽  
Coronary Blood Flow ◽  
Mental Stress ◽  
Coronary Flow ◽  
Neuronal Nitric Oxide Synthase ◽  
Coronary Artery Diameter ◽  
Oxide Synthase

Mental stress-induced ischemia approximately doubles the risk of cardiac events in patients with coronary artery disease, yet the mechanisms underlying changes in coronary blood flow in response to mental stress are poorly characterized. Neuronal nitric oxide synthase (nNOS) regulates basal coronary blood flow in healthy humans and mediates mental stress-induced vasodilation in the forearm. However, its possible role in mental stress-induced increases in coronary blood flow is unknown. We studied 11 patients (6 men and 5 women, mean age: 58 ± 14 yr) undergoing elective diagnostic cardiac catheterization and assessed the vasodilator response to mental stress elicited by the Stroop color-word test. Intracoronary substance P (20 pmol/min) and isosorbide dinitrate (1 mg) were used to assess endothelium-dependent and -independent vasodilation, respectively. Coronary blood flow was estimated using intracoronary Doppler recordings and quantitative coronary angiography to measure coronary artery diameter. Mental stress increased coronary flow by 34 ± 7.0% over the preceding baseline during saline infusion ( P < 0.01), and this was reduced to 26 ± 7.0% in the presence of the selective nNOS inhibitor S-methyl-l-thiocitrulline (0.625 µmol/min, P < 0.001). Mental stress increased coronary artery diameter by 6.9 ± 3.7% ( P = 0.02) and 0.5 ± 2.8% ( P = 0.51) in the presence of S-methyl-l-thiocitrulline. The response to substance P did not predict the response to mental stress ( r2 = −0.22, P = 0.83). nNOS mediates the human coronary vasodilator response to mental stress, predominantly through actions at the level of coronary resistance vessels. NEW & NOTEWORTHY Acute mental stress induces vasodilation of the coronary microvasculature. Here, we show that this response involves neuronal nitric oxide synthase in the human coronary circulation. Listen to this article’s corresponding podcast at http://ajpheart.podbean.com/e/nnos-and-coronary-flow-during-mental-stress/ .

scholarly journals The Association between Inflammatory Cytokines and miRNAs with Slow Coronary Flow Phenomenon

2020 ◽  
Author(s):  
Shahla Danaii ◽  
Sadaf Shiri ◽  
Sanam Dolati ◽  
Majid Ahmadi ◽  
Leila Ghahremani-Nasab ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Flow ◽  
Mononuclear Cells ◽  
Serum Levels ◽  
Control Group ◽  
Peripheral Blood Mononuclear ◽  
Slow Coronary Flow ◽  
Expression Levels ◽  
Healthy Control ◽  
Artery Disease

Slow coronary flow (SCF) is a coronary artery disorder. Several inflammatory mediators have been reported to be associated with vascular homeostasis and endothelial dysfunction. The aim of this study was to investigate the association between cytokines and miRNAs in patients with SCF compared to the controls. In this regard, blood samples were acquired from 45 SCF patients and 45 age- and sex-matched healthy control subjects. Serum and peripheral blood mononuclear cells (PBMCs) were separated. Expression levels of miRNAs and cytokines in PBMCs were measured by real-time PCR. As a final point, serum levels of cytokines were quantified by ELISA. Expression levels of miR-1, miR-133, miR-208a, miR-206, miR-17, miR-29, miR-223, miR-326, and miR-155 as considerable indicators of inflammatory function significantly increased in SCF patients while the expression levels of miR-15a, miR-21, miR-25, miR-126, miR-17, miR-16 and miR-18a as considerable indicators of anti-inflammatory function significantly decreased in patients with SCF compared to the control group. Additionally, serum IL-1β, IL‐8, and TNF-α concentrations were significantly higher in the SCF group than controls. However, no significant differences were observed in IL-10 production in SCF patients compared to the controls. This study provided the potential role of miRNAs as biomarkers for SCF diagnosis as well as suitable markers for monitoring coronary artery disease (CAD) development in these patients. More investigations are still necessary to unravel the detailed essential mechanisms of circulating miRNA levels in patients with heart failure and SCF.

Coronary artery diameter can be assessed reliably with transthoracic echocardiography

2004 ◽  
Vol 286 (4) ◽  
pp. H1515-H1520 ◽  
Author(s):  
Tuomas O. Kiviniemi ◽  
Markku Saraste ◽  
Juha W. Koskenvuo ◽  
K. E. Juhani Airaksinen ◽  
Jyri O. Toikka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Transthoracic Echocardiography ◽  
Coronary Flow ◽  
Interobserver Variability ◽  
Color Doppler ◽  
Correlation Coefficients ◽  
Quantitative Coronary Angiography ◽  
Accurate Method ◽  
Coronary Artery Diameter

We studied whether diameters of coronary arteries can be measured accurately with the use of transthoracic echocardiography (TTE). By knowing the anatomic diameter of the coronary artery together with coronary flow velocity it is possible to measure coronary flow volume more precisely by TTE. However, the suitability of TTE for measurement of diameters of all main epicardial coronary arteries has not been systematically validated. We measured the diameters of the left main (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary arteries (RCA) with the use of TTE [manual two-dimensional (2D), color-Doppler, and automated 2D analysis] in 30 patients who had normal coronary anatomy. We compared these diameters to those measured with quantitative coronary angiography (QCA). We could measure diameters of LM, LAD, LCX, and RCA by TTE in up to 37%, 63%, 7%, and 60% of patients, respectively. The overall correlation coefficients between TTE and QCA measurements were 0.83 ( P < 0.01) with manual 2D analysis, 0.82 ( P < 0.01) with automated 2D analysis, and 0.94 ( P < 0.01) with a color-Doppler-based analysis. Interobserver variability of TTE measurements was low (coefficient of variation 5.4 ± 4.6–7.5 ± 8.8%). TTE is an accurate method to evaluate coronary artery diameter in patients with healthy coronary arteries.

scholarly journals Prevalence and predictors of slow coronary flow phenomenon in Kermanshah province

2021 ◽  
Vol 13 (1) ◽  
pp. 37-42
Author(s):  
Mohammad Rouzbahani ◽  
Saeid Farajolahi ◽  
Nafiseh Montazeri ◽  
Parisa Janjani ◽  
Nahid Salehi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Flow ◽  
Study Data ◽  
Fisher Exact Test ◽  
Circumflex Artery ◽  
Serum Triglycerides ◽  
Cross Sectional ◽  
Flow Phenomenon ◽  
Slow Coronary Flow ◽  
Left Circumflex Artery

Introduction: This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon. Methods: This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon. Results: In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P<0.001), hyperlipidemic (44.2 vs. 31.7, P<0.001), hypertensive (53.5 vs. 39.1, P<0.001), and smoker (37.2 vs. 27.2, P=0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P<0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P<0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P<0.001) and hypertension (OR 1.59, CI 1.30-5.67, P=0.003) were independent predictors of SCF phenomenon. Conclusion: The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon.

scholarly journals Plasma Choline as a Diagnostic Biomarker in Slow Coronary Flow

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Yuan-Ting Zhu ◽  
Ling-Ping Zhu ◽  
Zhen-Yu Wang ◽  
Xue-Ting Qiu ◽  
Wan-Zhou Wu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Receiver Operating Characteristic ◽  
Coronary Flow ◽  
Operating Characteristic ◽  
Confounding Factor ◽  
Accurate Method ◽  
Diagnostic Biomarker ◽  
Roc Curve Analysis ◽  
Slow Coronary Flow ◽  
Receiver Operating

Aim. The slow coronary flow (SCF) phenomenon was characterized by delayed perfusion of epicardial arteries, and no obvious coronary artery lesion in coronary angiography. The prognosis of patients with slow coronary flow was poor. However, there is lack of rapid, simple, and accurate method for SCF diagnosis. This study aimed to explore the utility of plasma choline as a diagnostic biomarker for SCF. Methods. Patients with coronary artery stenosis <40% evaluated by the coronary angiogram method were recruited in this study and were grouped into normal coronary flow (NCF) and SCF by thrombolysis in myocardial infarction frame count (TFC). Plasma choline concentrations of patients with NCF and SCF were quantified by Ultra Performance Liquid Chromatography Tandem Mass Spectrometry. Correlation analysis was performed between plasma choline concentration and TFC. Receiver operating characteristic (ROC) curve analysis with or without confounding factor adjustment was applied to predict the diagnostic power of plasma choline in SCF. Results. Forty-four patients with SCF and 21 patients with NCF were included in this study. TFC in LAD, LCX, and RCA and mean TFC were significantly higher in patients with SCF in comparison with patients with NCF (32.67 ± 8.37 vs. 20.66 ± 3.41, P < 0.01). Plasma choline level was obviously higher in patients with SCF when compared with patients with NCF (754.65 ± 238.18 vs. 635.79 ± 108.25, P=0.007). Plasma choline level had significantly positive correlation with Mean TFC (r = 0.364, P=0.002). Receiver operating characteristic (ROC) analysis showed that choline with or without confounding factor adjustment had an AUC score of 0.65 and 0.77, respectively. Conclusions. TFC were closely related with plasma choline level, and plasma choline can be a suitable and stable diagnostic biomarker for SCF.

scholarly journals Prognostic value of non-invasive coronary artery flow velocity assessment in elderly patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Kalinina ◽  
A Zagatina ◽  
N Zhuravskaya ◽  
D Shmatov
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Flow Velocity ◽  
Coronary Arteries ◽  
Coronary Flow ◽  
Prognostic Value ◽  
Area Under Curve ◽  
Left Coronary Artery ◽  
Maximal Velocity

Abstract Funding Acknowledgements Type of funding sources: None. Background There is a high prevalence of coronary artery disease (CAD) in the elderly population. However, symptoms of CAD are often non-specific. Dyspnoe, non-anginal pains are among the main symptoms in older patients. Exercise tests are of limited feasibility in these patients, due to neuro-muscular weakness, physical deconditioning, and orthopaedic limitations. Pharmacological tests often are contraindicated in a substantial percentage of elderly patients. Some recent studies indicate using local flow acceleration during routine echocardiography has prognostic potential for coronary artery assessments without stress testing. The aim of the study was to define the prognostic value of coronary artery ultrasound assessment in patients ≥75 years old. Methods This is a prospective cohort study. Patients ≥ 75 years old who underwent routine echocardiography with additional scans for coronary arteries over a period of 24 months were included in the study. The study group consisted of 80 patients aged 75-90 years (56 women; mean age 79 ± 4). Initial exams were performed for other reasons, primarily for arterial hypertension. Fifteen patients had known CAD. Death, non-fatal myocardial infarction (MI), and revascularization were defined as major adverse cardiac events (MACE). All patients were followed up with at a median of 32 months. Results There were 34 patients with high local velocities in the left coronary artery. Eight deaths, two non-fatal myocardial infarctions occurred, and 13 revascularizations were performed. With a ROC analysis, a coronary flow velocity &gt;110 cm/s was the best predictor for risk of death (area under curve 0.84 [95% CI 0.74–0.92]; sensitivity 75%; specificity 88%). Only the maximal velocity in proximal left-sided coronary arteries was independently associated with death (HR 1.03, 95% CI 1.01; 1.05; p &lt; 0.002), or death/MI (HR 1.03, 95% CI 1.01; 1.04; p &lt; 0.0001). The cut-off value of 66 cm/s was a predictor of all MACE (area under curve 0.87 [95% CI 0.77–0.94]; sensitivity 80%; specificity 86%). Any causes of death or MI occurred more frequently in patients with velocities of &gt;66 cm/s (27% vs. 2%; p &lt; 0.002). The rates of MACE were 58.0% vs. 2%; p &lt; 0.0000001, respectively. Conclusion The analysis of coronary flow in the left coronary artery during echocardiography can be used as a predictor of outcomes in elderly patients. Maximal velocities in proximal left-sided coronary arteries is independently associated with further death or myocardial infarction.

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