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Evaluation of serum nitric oxide synthase levels in patients with coronary slow flow based on corrected TIMI frame
Jamal Shamsara1, Sepideh Elyasi2, Mostafa Dastani3
1Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
This study found no significant correlation between nitric oxide synthase (NOS) serum levels and coronary slow flow phenomenon (CSFP) in patients. Further human studies are needed to confirm these findings regarding NOS isoforms and CSFP.
Area of Science:
- Cardiology
- Biochemistry
- Vascular Biology
Background:
- Coronary slow flow phenomenon (CSFP) is characterized by delayed distal vessel filling on angiography without significant epicardial coronary artery disease.
- The endothelium plays a crucial role in cardiovascular homeostasis through vasoactive substance release, notably nitric oxide (NO).
- Nitric oxide synthase (NOS) exists in three isoforms: eNOS, nNOS, and iNOS, each with distinct roles.
Purpose of the Study:
- To investigate the role of nitric oxide synthase (NOS) in the development of coronary slow flow phenomenon (CSFP) in a human cohort.
- To determine the correlation between serum NOS levels and the severity of CSFP, quantified by the corrected TIMI frame count (CTFC).
Main Methods:
- 129 patients were categorized into five groups based on coronary angiography findings (presence/absence of CAD and CSFP).
- Serum levels of total NOS were measured in all participants.
- Coronary flow in CSFP patients was assessed using the corrected TIMI frame count (CTFC).
Main Results:
- No significant correlation was observed between total serum NOS levels and the mean CTFC in patients with CSFP.
- The lack of correlation may be attributed to a potential imbalance in NOS isoforms, such as increased iNOS and decreased eNOS concentrations.
Conclusions:
- The study did not find a direct correlation between overall serum NOS levels and the severity of CSFP.
- Further research involving human subjects is recommended to elucidate the specific roles of different NOS isoforms in CSFP pathogenesis.
Introduction:
The coronary slow flow phenomenon (CSFP) finding in angiography is characterized by the delayed filling of the terminal vessels without significant epicardial coronary disease. The endothelium performs a vital role in cardiovascular homeostasis by releasing vasoactive substances. Endothelial cells produce nitric oxide (NO) as one of these essential compounds. Three isoforms of nitric oxide synthase (NOS) are endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), and induced nitric oxide synthase (iNOS). We aimed to determine the role of NOS in the development of CSFP as the first human study.
Material And Methods:
A total of 129 patients who met the inclusion criteria were enrolled in the study. The patients were classified into five groups based on the results of coronary angiography: Group 1 without coronary artery disease (CAD) and without CSF, group 2 without CAD and with CSF, group 3 with CAD (< 50%) and without CSF, group 4 with CAD (50-90%) and without CSF, and group 5 with CAD and CSF. The serum level of NOS was determined in the participants. Coronary flow was quantified in patients with CSFP using the corrected TIMI frame count (CTFC) method, and the correlation between the levels of this biomarker and CTFC was investigated.
Results:
In this study, the NOS serum levels were not significantly correlated with the mean CTFC. Since the total amount of NOS was measured as a result of 3 isoforms of this enzyme, the lack of correlation could be related to increased iNOS level and decreased eNOS concentration.
Conclusions:
These results should be confirmed by more human studies.
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