Evaluation of blood rheology in patients with coronary slow flow or non-obstructive coronary artery disease

2013 ◽  
Vol 53 (4) ◽  
pp. 317-326 ◽  
Author(s):  
Muhammet Bilgi ◽  
Hakan Güllü ◽  
İlknur Kozanoğlu ◽  
Hakan Özdoğu ◽  
Nurzen Sezgin ◽  
...  
2019 ◽  
Vol 11 (3) ◽  
pp. 299-303
Author(s):  
Muhammad Diah ◽  
Rahmawati Rahmawati ◽  
Aznan Lelo ◽  
Zulfikri Muhktar ◽  
Dharma Lindarto ◽  
...  

BACKGROUND: Tumor necrosis factor (TNF)-α, an important primary pro-inflammatory cytokine, has a crucial role in the pathogenesis of atherosclerosis. Since the pathophysiological mechanism of coronary slow flow (CSF) is not fully understood, we investigated the level of TNF-α in coronary artery disease (CAD), CSF and healthy subjects.METHODS: This study was conducted in cross-sectional design involving 16 CAD, 18 CSF and 18 healthy subjects. Coronary angiography was recorded at the left anterior oblique, cranial, right anterior oblique, caudal, and horizontal positions. The flow in coronary arteries of the subjects were assessed using Thrombolysis in the Myocardial Infarction (TIMI) frame count method. Peripheral blood-derived serum was collected and level of TNF-α was determined by using highly sensitive enzymelinked immunosorbent assay (ELISA).RESULTS: No significant difference in level of TNF-α in CAD, CSF and healthy subjects (2.72±2.64 pg/mL, 1.88±0.8 pg/mL, 1.64±0.35 pg/mL, respectively) (p=0.087). In addition, there was no correlation between the concentration of TNF-α and TIMI frame count (r<0.2, p>0.05).CONCLUSION: There was no significant difference of TNF-α level in CAD, CSF and healthy subjects. In addition, there was no correlation between the TNF-α level with TIMI frame count as well. Nevertheless, further clinical studies with more subjects are needed.KEYWORDS: TNF-alpha, coronary artery disease, coronary slow flow 


2016 ◽  
Vol 44 (6) ◽  
pp. 1443-1453 ◽  
Author(s):  
Mücahid Yılmaz ◽  
Hasan Korkmaz ◽  
Mehmet Nail Bilen ◽  
Ökkeş Uku ◽  
Ertuğrul Kurtoğlu

Objective To determine whether neutrophil/lymphocyte ratio (NLR) differed between patients with isolated coronary artery disease (CAD), isolated coronary artery ectasia (CAE), coronary slow flow and normal coronary anatomy. Methods Patients who underwent coronary angiography were consecutively enrolled into one of four groups: CAD, coronary slow flow, CAE and normal coronary anatomy. Results The CAD ( n = 40), coronary slow flow ( n = 40), and CAE ( n = 40) groups had similar NLRs (2.51 ± 0.7, 2.40 ± 0.8, 2.6 ± 0.6, respectively) that were significantly higher than patients with normal coronary anatomy ( n = 40; NLR, 1.73 ± 0.7). Receiver operating characteristics demonstrated that with NLR > 2.12, specificity in predicting isolated CAD was 85% and sensitivity was 75%, with NLR > 2.22 specificity in predicting isolated CAE was 86% and sensitivity was 75%. With NLR > 1.92, specificity in predicting coronary slow flow was 89% and sensitivity was 75%. Multivariate logistic regression analyses identified NLR as an independent predictor of isolated CAE (β = −0.499, 95% CI −0.502, −0.178; P <  0.001), CAD (β = −0.426, 95% CI −1.321, −0.408; P <  0.001), and coronary slow flow (β = −0.430, 95% CI −0.811, −0.240; P = 0.001 Table 2 ). Conclusions NLR was higher in patients with CAD, coronary slow flow and CAE versus normal coronary anatomy. NLR may be an indicator of CAD, CAE and coronary slow flow.


2019 ◽  
Author(s):  
youfeng Liang ◽  
xianhe Lin ◽  
yuanyuan Xu ◽  
chunmiao Wang ◽  
Qi Zhou

Abstract Background: Atherosclerosis is a chronic inflammatory disease. The pathology underlying the disease consists of accumulation of the extracellular matrix, lipid and inflammatory cells. Coronary Slow Flow Phenomenon (CSFP) is closely related to inflammatory responses, while chemokines play an important role in the progression of atherosclerosis. However, the relationship between chemokines and CSFP is unclear. In this study, our aims were to evaluate the association between CXC Chemokines 9 (CXCL9) levels and CSFP in patients with coronary artery disease. Methods: We studied 46 patients diagnosed with CSFP and classed them as the CSFP group. 50 patients with normal coronary angiography (CAG) were randomly selected as the no-CSFP group in our study. The mean TIMI frame count was used to measure coronary blood flow velocity. The clinical and biochemical index, including serum levels of IL1, IL-6, IL-10, CXCL9, CD40L and interferon-γ (IFN-γ), were analyzed in all subjects. Results: The serum levels of IL-1, IL-6, IL-10, CXCL9, CD40L, IFN-γ and CXCL9 in the CSFP group were significantly higher than those in the no-CSFP group, with the differences being statistically significant (p<0.001). Furthermore, Pearson's correlation analysis reflected a significant positive correlation (r=0.171, p=0.01) in CXCL9 levels. Multivariate logistic regression analysis showed that CXCL9 are important risk factors for CSFP (β=1.795, P=0.000). Subsequent ROC curve analyses indicated that the serum CXCL9 levels demonstrated a high diagnostic value in differentiating patients with CSFP from that of normal controls (Area Under the Curve = 0.758) and the serum CXCL9 level of 131.915 mg/L was a predictor of CSFP, with a sensitivity of 54.3% and a specificity of 96.0%. Conclusions: Our findings are indicative of the potential clinical implications of CXCL9 in the occurrence and development of CSFP.


2020 ◽  
Vol 26 ◽  
Author(s):  
Maria Bergami ◽  
Marialuisa Scarpone ◽  
Edina Cenko ◽  
Elisa Varotti ◽  
Peter Louis Amaduzzi ◽  
...  

: Subjects affected by ischemic heart disease with non-obstructive coronary arteries constitute a population that has received increasing attention over the past two decades. Since the first studies with coronary angiography, female patients have been reported to have non-obstructive coronary artery disease more frequently than their male counterparts, both in stable and acute clinical settings. Although traditionally considered a relatively infrequent and low-risk form of myocardial ischemia, its impact on clinical practice is undeniable, especially when it comes to infarction, where the prognosis is not as benign as previously assumed. Unfortunately, despite increasing awareness, there are still several questions left unanswered regarding diagnosis, risk stratification and treatment. The purpose of this review is to provide a state of the art and an update on current evidence available on gender differences in clinical characteristics, management and prognosis of ischemic heart disease with non-obstructive coronary arteries, both in the acute and stable clinical setting.


2021 ◽  
Vol 10 (13) ◽  
pp. 2759
Author(s):  
Krzysztof Bryniarski ◽  
Pawel Gasior ◽  
Jacek Legutko ◽  
Dawid Makowicz ◽  
Anna Kedziora ◽  
...  

Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is a working diagnosis for patients presenting with acute myocardial infarction without obstructive coronary artery disease on coronary angiography. It is a heterogenous entity with a number of possible etiologies that can be determined through the use of appropriate diagnostic algorithms. Common causes of a MINOCA may include plaque disruption, spontaneous coronary artery dissection, coronary artery spasm, and coronary thromboembolism. Optical coherence tomography (OCT) is an intravascular imaging modality which allows the differentiation of coronary tissue morphological characteristics including the identification of thin cap fibroatheroma and the differentiation between plaque rupture or erosion, due to its high resolution. In this narrative review we will discuss the role of OCT in patients presenting with MINOCA. In this group of patients OCT has been shown to reveal abnormal findings in almost half of the cases. Moreover, combining OCT with cardiac magnetic resonance (CMR) was shown to allow the identification of most of the underlying mechanisms of MINOCA. Hence, it is recommended that both OCT and CMR can be used in patients with a working diagnosis of MINOCA. Well-designed prospective studies are needed in order to gain a better understanding of this condition and to provide optimal management while reducing morbidity and mortality in that subset patients.


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