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Pulse-Wave Velocity, Flow-Mediated Dilation, and Carotid Intima-Media Thickness to Assess Cardiovascular Risk in Population with Metabolic Syndrome
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Endothelial dysfunction and increased carotid intima-media thickness in the patients with slow coronary flow

Hyun Ju Yoon1, Myung Ho Jeong, Sook Hee Cho

  • 1The Heart Center of Chonnam National University Hospital, Gwangju, Korea.

Journal of Korean Medical Science
|June 13, 2012
PubMed

Insights

Endothelial dysfunction, indicated by reduced flow-mediated brachial dilatation (FMD), is linked to slow coronary flow in patients with angina, even before carotid intima-media thickness (IMT) changes appear.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Atherosclerosis Research

Background:

  • Flow-mediated brachial dilatation (FMD) and carotid intima-media thickness (IMT) are established markers for early atherosclerosis.
  • Slow coronary flow in patients with normal coronary angiograms presents an unclear pathogenetic mechanism.

Purpose of the Study:

  • To investigate the relationship between endothelial function, arterial stiffness, and slow coronary flow.
  • To determine if endothelial dysfunction precedes structural changes like increased IMT in slow coronary flow.

Main Methods:

  • Evaluated 85 angina patients using brachial artery FMD, carotid IMT, and coronary angiography.
  • Quantified coronary flow with the corrected TIMI frame count method.
  • Compared patients with normal coronaries (Group I) to those with slow flow (Group II).

Main Results:

  • Group II (slow flow) exhibited significantly lower FMD compared to Group I.
  • Elevated heart rate, dyslipidemia, and higher white blood cell counts (monocytes) and homocysteine were noted in Group II.
  • Regression analysis identified elevated heart rate, dyslipidemia, and low FMD as independent predictors of slow coronary flow.

Conclusions:

  • Endothelial dysfunction, evidenced by reduced FMD, is strongly associated with slow coronary flow.
  • Endothelial dysfunction may represent an earlier vascular abnormality than increased carotid IMT in this patient cohort.

Keywords:
Carotid IntimaCoronary ArteryEndothelium

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