Related Experiment Video
Updated: Sep 24, 2025
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Relationship between carotid artery stiffness and total serum homocysteine in coronary slow flow phenomenon: a
1Department of Ultrasonography, Affiliated to Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Elevated serum homocysteine (tHcy) levels and increased carotid artery stiffness are linked to coronary slow flow phenomenon (CSFP). The β index of carotid artery stiffness best predicts CSFP, suggesting a systemic vascular disorder.
Area of Science:
- Cardiology
- Vascular Biology
- Biochemistry
Background:
- Coronary slow flow phenomenon (CSFP) is a common finding in coronary angiography.
- Disordered serum homocysteine (tHcy) metabolism and elevated tHcy levels are implicated in CSFP pathogenesis and atherosclerosis.
- The relationship between carotid artery stiffness and serum tHcy in CSFP patients requires further investigation.
Purpose of the Study:
- To evaluate the association between carotid artery stiffness and serum tHcy levels in patients diagnosed with CSFP.
- To identify predictors of CSFP, focusing on carotid artery stiffness parameters and tHcy levels.
Main Methods:
- A case-control study involving 146 patients with stable angina (73 with CSFP, 73 controls).
- All participants underwent coronary angiography, carotid ultrasonography, and biochemical analysis.
- Carotid artery stiffness parameters (β index, Ep, PWV, AC) and serum tHcy levels were measured.
Main Results:
- Patients with CSFP exhibited significantly higher carotid artery stiffness (β index, Ep, PWV) and lower arterial compliance (AC) compared to controls.
- Elevated serum tHcy concentrations and lower Thrombolysis In Myocardial Infarction (TIMI) frame counts were observed in the CSFP group.
- Serum tHcy levels positively correlated with carotid artery stiffness parameters (β, Ep, PWV) and negatively with AC.
- The left and right β index were identified as the strongest predictors of CSFP.
Conclusions:
- Elevated serum tHcy levels and increased carotid artery stiffness are significantly associated with CSFP.
- Carotid artery stiffness, particularly the β index, serves as a valuable predictor for CSFP.
- These findings suggest that CSFP may be part of a broader systemic vascular dysfunction rather than an isolated coronary issue.
Background:
Coronary slow flow phenomenon (CSFP) is not uncommon in conventional coronary angiography. A disorder of serum homocysteine (tHcy) metabolism may play a role in the pathogenesis of slow coronary flow. Moreover, elevated tHcy concentration is closely associated with atherosclerosis. We aimed to evaluate the relationship between carotid artery stiffness and serum tHcy levels in patients with CSFP.
Methods:
This was a case-control study. The study population comprised 146 patients with newly diagnosed stable angina, including 73 patients with CSFP and 73 patients with normal coronary flow. All participants underwent conventional coronary angiography, carotid ultrasonography, and biochemical examination.
Results:
The carotid artery stiffness parameters of β index (β), pressure-strain elastic modulus (Ep), and local pulse wave velocity (PWV) in the CSFP group were significantly higher than those in the control group (β: 10.75±2.16 vs. 9.02±2.11, P=0.007; Ep: 147.41±41.22 vs. 116.21±39.21, P=0.004; PWV: 7.45±1.23 vs. 6.16±1.20, P=0.003), However, arterial compliance (AC) was lower in the CSFP group than the control group (0.52±0.11 vs. 0.69±0.24, P=0.008). The mean thrombolysis in myocardial infarction (TIMI) frame count and the tHcy concentration in the CSFP group were significantly higher than those in the control group (48.60±1.30 vs. 24.50±3.80, P=0.001; 19.95±4.00 vs. 9.12±2.72, P=0.009). The tHcy concentration was positively correlated with β (R value =0.494, P<0.0001), Ep (R value =0.469, P<0.0001), and PWV (R value =0.436, P<0.0001), but negatively correlated with AC (R value =-0.230, P=0.022). The predictors of CSFP were tHcy concentration, left PWV, right PWV, left β index, and right β index. Among them, the left β index and right β index were the best indictors for predicting CSFP. The cutoff values of left β index, right β index, left PWV, and right PWV were 9.3, 9.3, 6.7, and 6.6, respectively.
Conclusions:
Our data showed that serum tHcy levels were elevated in patients with CSFP compared with the control group. Carotid artery stiffness parameters were correlated with tHcy. The best predictors of CSFP were left β index and right β index. These findings may contribute to a better understanding of systemic vascular disorders in patients with coronary slow flow, rather than simply attributing such disorders to a single and isolated lesion of the epicardial coronary artery.
