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Echocardiographic and laboratory findings in coronary slow flow phenomenon: cross-sectional study and review
Mir Hosein Seyyed Mohammadzad1, Kamal Khademvatani1, Salar Gardeshkhah1
1Cardiology Department, Medical Faculty, Urmia University of Medical Sciences, 17 Shahrivar St., 571478334, Urmia, Iran.
Insights
Coronary slow-flow phenomenon (CSFP) is more prevalent in men, smokers, and hypertensive individuals with higher BMI. These patients exhibit elevated platelet counts, LDL, and diastolic dysfunction, indicating potential cardiovascular risks.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Coronary slow-flow phenomenon (CSFP) is characterized by delayed contrast transit in coronary arteries without discernible obstructions.
- Understanding the risk factors and clinical correlates of CSFP is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the demographic, clinical, laboratory, and echocardiographic characteristics associated with CSFP.
- To identify predictors of CSFP in patients undergoing coronary angiography.
Main Methods:
- A cross-sectional, descriptive-analytical study was conducted involving 124 patients.
- Patients were categorized into a CSFP group and a control group with normal coronary arteries.
- Data collected included demographics, medical history, laboratory tests, and echocardiographic parameters.
Main Results:
- CSFP was significantly more common in males, smokers, hypertensive patients, and those with higher BMI (p < 0.05).
- Elevated levels of platelet count, mean platelet volume (MPV), low-density lipoprotein (LDL), and fasting blood sugar (FBS) were observed in the CSFP group.
- Echocardiography revealed lower mean E wave and significantly reduced global longitudinal strain (GLS) in patients with CSFP, suggesting mild diastolic dysfunction.
Conclusions:
- CSFP is associated with male gender, smoking, hypertension, and obesity.
- Specific laboratory markers and echocardiographic findings, including diastolic dysfunction and reduced GLS, are linked to CSFP.
- These findings highlight potential underlying pathophysiological mechanisms and risk factors for CSFP.
Background:
Coronary sow-flow phenomenon (CSFP) is defined as slow passage of the contrast injected into the coronary arteries without distal obstruction of the vessel.
Methods:
The present study was a cross-sectional, descriptive-analytical study performed at the Seyed-al-Shohada Heart Center during 2018-2019. The eligible patients based on the inclusion and exclusion criteria were divided into the study group showing the CSFP and the control group with normal epicardial coronary arteries.
Results:
The study included 124 patients. 67.9% of the study group and 39.4% of the control group were male patients (p-value = 0.001), and the mean patient age was 52.18 ± 12.55 and 51.77 ± 10.36 years in the study and control groups, respectively (p-value = 0.18). The study group had a significantly higher BMI than the control group (p < 0.05) and also a higher prevalence of smoking and hypertension. The variables of ALC, Hct, Plt, MPV, RDW, Cr, triglyceride, TC, and LDL, were higher in the study group. Given the echocardiographic findings, the mean E wave was significantly lower in the study group, while the control group had a significantly higher GLS (p-value = 0.01). Also, left anterior descending artery was the most common artery involved with CSFP.
Conclusion:
The CSFP was significantly more common in men, smokers, hypertensive patients, and patients with high BMI. Moreover, these patients had significantly higher platelet count, MPV, LDL, and FBS. Some other laboratory variables were also higher in these patients. Given the echocardiographic findings, mild diastolic dysfunction and low GLS were also observed in the study group.
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