Endothelial dysfunction and increased carotid intima-media thickness in the patients with slow coronary flow

• Published in: Journal of Korean medical science Vol. 27; no. 6; pp. 614 - 618
• Main Authors: Yoon, Hyun Ju, Jeong, Myung Ho, Cho, Sook Hee, Kim, Kye Hun, Lee, Min Goo, Park, Keun Ho, Sim, Doo Sun, Yoon, Nam Sik, Hong, Young Joon, Kim, Ju Han, Ahn, Youngkeun, Cho, Jeong Gwan, Park, Jong Chun, Kang, Jung Chaee
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.06.2012; 대한의학회
• Subjects: Aged; Angina, Unstable - complications; Angina, Unstable - diagnostic imaging; Angina, Unstable - physiopathology; Brachial Artery - physiopathology; Carotid Intima-Media Thickness; Coronary Angiography; Coronary Circulation - physiology; Dyslipidemias - complications; Endothelium, Vascular - physiopathology; Female; Heart Rate; Homocysteine - metabolism; Humans; Leukocyte Count; Male; Middle Aged; Monocytes - cytology; Original; Regression Analysis; Risk Factors; ROC Curve; 의학일반; Coronary Artery; Carotid Intima; Endothelium
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2012.27.6.614

Flow mediated brachial dilatation (FMD) and carotid intima-media thickness (IMT) have been a surrogate for early atherosclerosis. Slow coronary flow in a normal coronary angiogram is not a rare condition, but its pathogenesis remains unclear. A total of 85 patients with angina were evaluated of their brachial artery FMD, carotid IMT and conventional coronary angiography. Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count method. Group I was a control with normal coronary angiography (n = 41, 56.1 ± 8.0 yr) and group II was no significant coronary stenosis with slow flow (n = 44, 56.3 ± 10.0 yr). Diabetes was rare but dyslipidemia and family history were frequent in group II. Heart rate was higher in group II than in group I. White blood cells, especially monocytes and homocysteine were higher in group II. The FMD was significantly lower in group II than in group I. Elevated heart rate, dyslipidemia and low FMD were independently related with slow coronary flow in regression analysis. Therefore, endothelial dysfunction may be an earlier vascular phenomenon than increased carotid IMT in the patients with slow coronary flow.