J Korean Med Sci.  2012 Jun;27(6):614-618. 10.3346/jkms.2012.27.6.614.

Endothelial Dysfunction and Increased Carotid Intima-Media Thickness in the Patients with Slow Coronary Flow

• Yoon HJ
• Jeong MH
• Cho SH
• Kim KH
• Lee MG
• Park KH
• Sim DS
• Yoon NS
• Hong YJ
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 1421612
• DOI: http://doi.org/10.3346/jkms.2012.27.6.614

Abstract

Flow mediated brachial dilatation (FMD) and carotid intima-media thickness (IMT) have been a surrogate for early atherosclerosis. Slow coronary flow in a normal coronary angiogram is not a rare condition, but its pathogenesis remains unclear. A total of 85 patients with angina were evaluated of their brachial artery FMD, carotid IMT and conventional coronary angiography. Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count method. Group I was a control with normal coronary angiography (n = 41, 56.1 +/- 8.0 yr) and group II was no significant coronary stenosis with slow flow (n = 44, 56.3 +/- 10.0 yr). Diabetes was rare but dyslipidemia and family history were frequent in group II. Heart rate was higher in group II than in group I. White blood cells, especially monocytes and homocysteine were higher in group II. The FMD was significantly lower in group II than in group I. Elevated heart rate, dyslipidemia and low FMD were independently related with slow coronary flow in regression analysis. Therefore, endothelial dysfunction may be an earlier vascular phenomenon than increased carotid IMT in the patients with slow coronary flow.

Keyword

Endothelium; Coronary Artery; Carotid Intima

MeSH Terms

Aged
Angina, Unstable/complications/physiopathology/ultrasonography
Brachial Artery/physiopathology
*Carotid Intima-Media Thickness
Coronary Angiography
Coronary Circulation/*physiology
Dyslipidemias/complications
Endothelium, Vascular/*physiopathology
Female
Heart Rate
Homocysteine/metabolism
Humans
Leukocyte Count
Male
Middle Aged
Monocytes/cytology
ROC Curve
Regression Analysis
Risk Factors
Homocysteine

Figure

• 

  Fig. 1 Differences of endothelial and vascular smooth muscular function. FMD, flow mediated dilatation; NMD, nitrogen mediated dilatation.

• 

  Fig. 2 Receiver operator characteristics curves of slow coronary flow. Arrow means cut off value of FMD (Area under the curve = 0.787, sensitivity = 0.773, specificity = 0.732).

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