scholarly journals The Role of AT1R A1166C Gene Polymorphism in Coronary Slow Flow Phenomenon of Undergoing Coronary Angiography Patients

2020 ◽  
Vol 8 (A) ◽  
pp. 932-937
Author(s):  
Taufik Indrajaya ◽  
Mgs Irsan Saleh ◽  
Alpian Alpian
Keyword(s):  
Coronary Angiography ◽  
Gene Polymorphism ◽  
Restriction Enzymes ◽  
Acid Extraction ◽  
Slow Flow ◽  
Genotype Distribution ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

BACKGROUND: The presence of gene polymorphisms in the renin-angiotensin-aldosterone system associated with an impaired endothelial function that causes atherosclerosis and also myocardial fibrosis such as the polymorphism of the angiotensin-converting enzyme gene and the angiotensin I receptor (AT1R) gene. AIM: This research was aimed to explore the role of AT1R A1166C gene polymorphism in the incidence of coronary slow flow phenomenon (CSFP) in the Malay population, South Sumatra, Indonesia. METHODS: This study is a comparative analysis using a case-control study design to analyze the effect of the AT1R A1166C gene polymorphism on the incidence of slow flow phenomenon in patients undergoing elective coronary angiography at Mohammad Hoesin Hospital Palembang, Indonesia. Examination of AT1R gene polymorphism was carried out with several steps starting from deoxyribonucleic acid extraction, polymerase chain reaction process, followed by restriction fragment length polymorphism stages with Ddel restriction enzymes and visualization. RESULTS: Thirty-two patients participated in these study-baseline characteristics between homogeneous coronary regular flow groups and homogeneous coronary slow flow groups. There is no difference between genotype distribution, allele frequency, and genotype between the CSFP and the coronary standard flow group. CONCLUSION: There is no influence of AT1R A1166C gene polymorphism on the CSFP in patients undergoing coronary angiography.

scholarly journals The Effect of Angiotensin-Converting Enzyme Gene Polymorphisms in the Coronary Slow Flow Phenomenon at South Sumatra, Indonesia Population

2020 ◽  
Vol 8 (A) ◽  
pp. 225-230
Author(s):  
Ali Ghanie ◽  
Radiyati Umi Partan ◽  
Taufik Indrajaya ◽  
Zulkhair Ali ◽  
Mgs Irsan Saleh ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Linked Immunosorbent Assay ◽  
Slow Flow ◽  
Converting Enzyme ◽  
Angiotensin I ◽  
Flow Phenomenon ◽  
Two Samples ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

BACKGROUND: The coronary slow flow phenomenon (CSFP) is believed to be affected by endothelial dysfunction ruled by renin, angiotensin, aldosterone, and the angiotensin-converting enzyme (ACE). The gene of ACE has been characterized in humans by a major insertion (I)/deletion (D) polymorphism. Serum ACE levels were associated with I/D polymorphism in the ACE-encoding gene. AIM: This study explored and analyzed the role of ACE gene polymorphism risk factors with the incidence of CSFP in the population of South Sumatra, Indonesia. METHODS: This study was a cross-sectional analytic observational study. A total of 112 CSFP and non- CSFP patients participated in this study. Blood was obtained from the study subjects then processed. Angiotensin I and aldosterone levels were examined using the enzyme-linked immunosorbent assay. The Judkins method was used in the assessment of coronary angiography, which was carried out through the femoral artery. For the examination of ACE I/D polymorphisms, genome deoxyribonucleic acid was extracted from blood cells (leukocytes), using the Wizard’s purification system and examined using the polymerase chain reaction method. All data were evaluated through the Chi-square test, two samples t-test, and Mann–Whitney U-test. All tests used two-sided significance and p < 0.05 was considered statistically significant. RESULTS: ACE I/D gene polymorphism possessed a significant effect in increasing the risk of CSFP. Genotype II polymorphism increased the risk of CSFP as much as 6.9 times compared to individuals with ID/DD genotype. The existence of allele I increased the risk of CSFP 5.7 times compared to allele D. Levels of angiotensin I and aldosterone were increased significantly in patients with CSFP. CONCLUSION: ACE I/D gene polymorphism possessed a significant effect in increasing the risk of CSFP. Genotype of II was the risk factor for the development of CSFP in population of South Sumatra, Indonesia.

scholarly journals Role of Fibroblast Growth Factor-23 in Coronary Slow Flow Phenomenon Pathogenesis

2021 ◽  
Vol 5 (4) ◽  
pp. 1029-1044
Author(s):  
Welly Oktaviandani ◽  
Taufik Indrajaya ◽  
Ali Ghanie ◽  
Erwin Sukandi
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Fibroblast Growth Factor 23 ◽  
Slow Flow ◽  
Fibroblast Growth ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon ◽  
Fgf 23

The phenomenon of angina chest pain without significant epicardial coronary artery stenosis, but accompanied by a slowdown in coronary blood flow is often found in patients with symptoms of acute coronary syndrome who undergoing invasive coronary angiography. This phenomenon of slow coronary blood flow is then called the coronary slow flow phenomenon (CSFP). The pathogenesis mechanism of CSFP remains unclear. The pathogenesis of CSFP is thought to be multifactorial. Endothelial dysfunction, small vessel disease, inflammation, renin system angiotensin aldosterone, atherosclerosis are thought to be involved in the pathogenesis of CSFP. Cardiovascular disease incidence and death were associated with elevated levels of Fibroblast growth factor-23 (FGF-23). High levels of FGF-23 can lead to formation of blood vessel calcification, left ventricular hypertrophy, arterial stiffness, endothelial dysfunction, increased inflammatory markers and elevated levels of angiotensin II. It is suspected that FGF-23 has a role in this event other than as a regulator of bone and mineral metabolism. This literature review aims to determine the relationship between fibroblast growth factor-23 and the pathophysiology of CSFP. Based on the broad role of FGF-23, it is possible that FGF-23 is involved in the pathogenesis of CSFP.

scholarly journals Coronary Slow Flow Phenomenon: The Role of New Echo cardiographic Indices

2020 ◽  
Vol 88 (9) ◽  
pp. 1783-1792
Author(s):  
MAGDY M. ABDELSAMEI, M.D.; MOHAMED GOUDA MOHAMED, M.D. ◽  
ISLAM M. ABDELMONEM, M.Sc.; AHMED S. ELDAMANHORY, M.D.
Keyword(s):  
Slow Flow ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

scholarly journals Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon

2022 ◽  
Vol 6 (3) ◽  
pp. 1435-1442
Author(s):  
Erwin Sukandi ◽  
Yudhie Tanta ◽  
Taufik Indrajaya ◽  
Ali Ghanie ◽  
Muhammad Irsan Saleh ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Coronary Vessels ◽  
P Wave ◽  
Attractive Alternative ◽  
Slow Flow ◽  
P Wave Dispersion ◽  
Diagnostic Modality ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.

scholarly journals TCTAP A-105 Coronary Slow Flow Phenomenon (CSFP) – Assessment of the Role of Endothelial Dysfunction

2016 ◽  
Vol 67 (16) ◽  
pp. S50-S51
Author(s):  
Sujai Nikhil Ramakrishnan ◽  
Arun prasath Palamalai ◽  
Ashwin Lysander ◽  
Raghava Chowdary ◽  
Ashish Kansal
Keyword(s):  
Endothelial Dysfunction ◽  
Slow Flow ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

scholarly journals The relationship between triglyceride/high-density lipoprotein cholesterol ratio and coronary slow-flow phenomenon

2021 ◽  
Author(s):  
Gonul Aciksari ◽  
Gokhan CETINKAL ◽  
Mehmet KOCAK ◽  
Adem Atici ◽  
Fatma Betul Celik ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Slow Flow ◽  
Flow Phenomenon ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon ◽  
The Relationship

Abstract Purpose: In this study, we aimed to investigate the relationship between high triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio and coronary slow-flow phenomenon (CSFP) in patients undergoing elective coronary angiography for suspected coronary artery disease. Methods: This prospective study included a total of 84 CSFP patients and 83 controls with normal coronary flow, as evidenced by coronary angiography. The Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) was used to measure the coronary blood flow velocity. The lipid profiles were analyzed and TG/HDL-C ratio were calculated dividing absolute TG levels by absolute HDL-C levels in peripheral blood. Results: The median TG/HDL-C ratio was higher in the CSFP group than the control group (3.4 [2.6 to 4.9] vs. 2.3 [1.8 to 3], respectively; p<0.001). The multivariate logistic regression analysis revealed that TG/HDL-C ratio was an independent predictor of CSFP (odds ratio [OR]: 1.78, 95% confidence interval [CI]: 1.59-2.32; p=0.001) and TG/HDL-C ratio was positively correlated with the TFC in the CSFP group ( r =0.311, p<0.001). The area under the receiver operating characteristic curve of TG/HDL-C for the diagnosis of CSFP was 0.73 (95% CI: 0.65-0.81; p<0.001). If a cut-off value of 2.75 was used, higher levels of TG/HDL-C ratio could predict the presence of CSFP with 72% sensitivity and 71% specificity. Conclusion: Our study results suggest that TG/HDL-C ratio is associated with CSFP and may be a useful biomarker for predicting CSFP and its severity.

scholarly journals ACUTE CORONARY SYNDROME WITH NONOBSTRUCTIVE CORONARY ARTERIES: THE SEVERITY OF CORONARY ATHEROSCLEROSIS AND MYOCARDIAL PERFUSION DISORDERS (PILOT STUDY)

2019 ◽  
Vol 34 (2) ◽  
pp. 71-78
Author(s):  
D. A. Vorobeva ◽  
A. V. Mochula ◽  
A. E. Baev ◽  
V. V. Ryabov
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Invasive Coronary Angiography ◽  
Atherosclerotic Plaques ◽  
Slow Flow ◽  
Flow Phenomenon ◽  
Coronary Syndrome ◽  
Coronary Slow Flow ◽  
Coronary Slow Flow Phenomenon

Aim. To study the structural and functional status of coronary blood flow in patients with acute coronary syndrome with nonobstructive coronary arteries using multispiral computed tomography (MSCT) and single photon emission tomography (SPECT) and to compare data of MSCT and invasive coronary angiography (ICA).Material and Methods. This study is a non-randomized, open-label, controlled clinical trial. The study is registered on ClinicalTrials.gov. The inclusion criteria are listed on the site. All patients underwent CT and SPECT.Results. The study included 14 patients with MINOCA; the group comprised predominantly women (n=11, 78.6%); the average age was 61.1±14 years. The risk according to GRACE (Global Registry of Acute Coronary Events) risk score was moderate in 8 patients (57%) and high in 5 patients (35.7%). 85.7% of patients were admitted to hospital within the first six hours from onset of diseases. Three patients (21.4%) received thrombolytic therapy and it was effective in two of them (14%). Risk factors included hypertension (64.2%), dyslipidemia (50%), and burdened history (71.4). According to the results of invasive coronary angiography, intact coronary arteries were detected in 9 patients (64.3%); 5 patients (35.7%) had stenosis up to 50%. Coronary slow-flow phenomenon (TIMI 2) was detected in 11 patients (78.6%) including 8 patients (57.1%) who had coronary slow-flow phenomenon and intact coronary arteries. Severe coronary spasm was registered in 1 patient (7.1%) in the group with ST segment elevation acute coronary syndrome (STE ACS). According to MSCT data, the proportion of patients with intact coronary arteries decreased from 7 (50%) to 5 patients (35.7%) whereas the proportion of patients with nonstenosing atherosclerosis increased from 7 (50%) to 9 patients (64.3%). Twenty six atherosclerotic plaques were detected including eccentric (76%), circular (11.5%), and semi-circular plaques (11.5%). In regard to morphological structure, the atherosclerotic plaques were calcified (59.5%), mostly calcified (7.7%), and soft (29%). Normal myocardial perfusion (Summed Stress Score (SSS) and Summed Rest Score (SRS) <4) was detected in two patients (14.3%); 12 patients (85%) had transitory perfusion defects. The median score values were 7.5 (4; 13) for SSS, 4.7 (1.0; 9.0) for SRS, and 4.7 (3.0; 8.0) for SDS.Conclusion. The introduction of MCTA and SPECT into the algorithm of the examination of patients with acute myocardial infarction and non-obstructive atherosclerosis of the coronary arteries was safe when additionally used during index hospitalization. These approaches provided new information about the structure and function of the coronary arteries. These data provide rationale for further study using a larger group of patients to determine a prognostic significance of detecting the atherosclerotic plaques with the signs of instability in this patient category.

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