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Assessment of coronary blood flow in non-ischemic dilated cardiomyopathy with the TIMI frame count method
Ayşe Saatçi Yaşar1, Emine Bilen, Isa Oner Yüksel
1Department of Cardiology, Atatürk Training and Research Hospital, Ankara, Turkey. drasaatciyasar@yahoo.com
Insights
Patients with idiopathic dilated cardiomyopathy have impaired coronary blood flow, indicated by higher Thrombolysis in Myocardial Infarction (TIMI) frame counts in normal coronary arteries compared to healthy individuals.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Idiopathic dilated cardiomyopathy (IDCM) is a condition affecting the heart's main pumping chamber.
- Assessing coronary blood flow is crucial for understanding cardiac health in IDCM patients.
Purpose of the Study:
- To evaluate coronary blood flow using the Thrombolysis in Myocardial Infarction (TIMI) frame count in patients with IDCM.
- To compare coronary blood flow in IDCM patients with angiographically normal coronary arteries against healthy controls.
Main Methods:
- Retrospective analysis of 62 IDCM patients and 62 controls with normal coronary arteries.
- Measurement of TIMI frame count for major coronary arteries (LAD, LCx, RCA).
- Statistical comparison using Student's t test, Chi-square, and Pearson correlation.
Main Results:
- Significantly higher TIMI frame counts were observed in IDCM patients across all three major coronary arteries compared to controls (p<0.003 for all).
- TIMI frame count showed a weak positive correlation with left ventricular end-diastolic and end-systolic diameters (r=0.350, r=0.358; p<0.001).
Conclusions:
- Patients with IDCM and normal coronary arteries exhibit impaired coronary blood flow.
- Elevated TIMI frame counts in IDCM suggest microvascular dysfunction even with unobstructed epicardial arteries.
Objective:
We aimed to evaluate coronary blood flow by means of the TIMI (Thrombolysis in Myocardial Infarction) frame count in patients with idiopathic dilated cardiomyopathy who had angiographically proven normal coronary arteries and compare the results with those of healthy subjects.
Methods:
This retrospective study included 62 patients with idiopathic dilated cardiomyopathy (34 men, 28 women; mean age 59.7 ± 10.6 years) and 62 control subjects without dilated cardiomyopathy (28 men, 34 women; mean age 56.6 ± 9.8 years). All patients and control subjects had angiographically proven normal coronary arteries. Dilated cardiomyopathy patients had a left ventricular ejection fraction =45%. The TIMI frame count was determined for each major coronary artery in each patient. Statistical analysis was performed using Student's t test, Chi-square test and Pearson correlation analysis.
Results:
The TIMI frame counts for each major epicardial coronary artery were found to be significantly higher in patients with idiopathic dilated cardiomyopathy compared to control subjects (corrected TIMI frame count for left anterior descending coronary artery: 37.0 ± 12.5 vs 28.7 ± 11.6, respectively, p=0.001; left circumflex coronary artery: 37.7 ± 12.1 vs 31.0 ± 12.5, respectively, p=0.003; right coronary artery: 37.4 ± 12.6 vs 30.7 ± 11.6, respectively, p=0.003). Mean TIMI frame count had significant although weak positive correlation with left ventricular end-diastolic diameter (r=0.350, p=0.001) and left ventricular end-systolic diameter (r=0.358, p=0.001).
Conclusion:
We have shown that patients with idiopathic dilated cardiomyopathy and angiographically normal coronary arteries have higher TIMI frame counts for all three coronary vessels, indicating impaired coronary blood flow, compared to control subjects without dilated cardiomyopathy.
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