Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echoca...Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography （TTDE） in the diagnosis and monitoring of coronary slow flow in left anterior descending （LAD） coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction （TIMI） frame count （CTFC） was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities （DPV） and diastolic mean velocities （DMV） were calculated.Results Sixty of 65 （92.3%） subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group （（0.228±0.029） m/s vs. （0.302±0.065） m/s, P=0.000; （0.176±0.028） m/s vs. （0.226±0.052） m/s, P=0.000,respectively）. There was a high inverse correlation between CTFC and coronary DPV and DMV （r=-0.727, P=0.000;r=-0.671, P=0.000, respectively）. Receiver operating characteristic （ROC） curve showed that the area under the curve （AUC） was less than one half for coronary DPV （AUC=0.104） and DMV （AUC=0.204）, respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.展开更多
In order to study the mechanism of angiographic coronary slow flow phenomenon (SF), intracoronary ultrasound (ICUS) and Doppler (ICD) were performed in 14 patients with angiographic SF phenomenon but with normal angio...In order to study the mechanism of angiographic coronary slow flow phenomenon (SF), intracoronary ultrasound (ICUS) and Doppler (ICD) were performed in 14 patients with angiographic SF phenomenon but with normal angiograms and in 16 patients with normal angiographic coronary flow (NF). A 3.5 F, 20 MHz ultrasound catheter (Boston Scientific) was used for ICUS and a 0.014 inch FloWire (Cardiometrics) was used for ICD. Coronary flow velocity including average peak velocity (APV), maximal peak velocity (MPV) at rest and at hyperemia as well as coronary flow reserve (CFR) were compared in both groups in comparison to the presence or absence of plaque formation based on ICUS. CFR in the SF group (4.2±1.1) was even higher than that of the NF group (3.1±0.6, P<0.001). Department of Cardiology, University GHS Essen, Germany (Ge JB, Simon H, Jeremias A, Liu FQ, Grge G, Haude M, Baumgart D and Erbel R) Significant differences were also found concerning the APV and MPV among both groups (both P <0.001). Plaque formation was found in 7/13 patients with a lumen reduction of 21%±24% in SF group and in 7/16 of the NF group with a lumen reduction of 19%±17%. Comparison of APV, MPV and CFR in SF and NF grups. Comparison of APV, MPV and CFR in SF and NF groups[BHDFG1*2,WK8ZQ1,WK11DW,WK11DWW] SF group NF groupAPV (cm/s) Rest 7.7±2.0 21.1±5.0 * Peak31.7±14.961.3±14.2 *MPV (cm/s) Rest17.4±4.637.0±11.4 * Peak56.8±14.981.8±17.7 *CFR4.2±1.13.1±0.6 # * P<0.001, #P=0.002. Coronary slow flow phenomenon in angiography indicates reduced resting flow velocity without reduction of coronary flow reserve.展开更多
Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focuse...Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies,clinical manifestations and treatment of this unique angiographic phenomenon. In our case report,we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries,especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.展开更多
目的探讨焦虑、抑郁状态与冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的关系,以及氟哌噻吨美利曲辛对冠状动脉慢血流现象合并焦虑、抑郁患者的治疗效果。方法选取2015年1月-2018年8月于解放军第305医院行冠状动脉造影检...目的探讨焦虑、抑郁状态与冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的关系,以及氟哌噻吨美利曲辛对冠状动脉慢血流现象合并焦虑、抑郁患者的治疗效果。方法选取2015年1月-2018年8月于解放军第305医院行冠状动脉造影检查诊断为冠状动脉造影血管正常且血流正常患者120例(正常组)和冠状动脉慢血流现象患者120例(CSFP组),比较两组抑郁自评量表(PHQ-9)及焦虑自评量表(GAD-7)评分结果。进一步从冠状动脉慢血流现象组(CSFP组)筛选出合并焦虑或者抑郁患者共54例,将这些筛选出的合并焦虑、抑郁的患者按随机数字表法进一步分为对照组27例及观察组27例,对照组给予阿司匹林等常规治疗,观察组在常规治疗基础上加用氟哌噻吨美利曲辛。疗程为6个月,观察两组治疗后的临床疗效。结果与正常对照组相比,冠状动脉慢血流现象组抑郁和焦虑状态得分更高:冠状动脉慢血流现象组的GAD-7评分、PHQ-9评分均显著高于正常组(6.44±2.91 vs 4.37±2.15;7.41±2.23 vs 4.52±1.91;P均<0.05),提示焦虑、抑郁与冠状动脉慢血流现象具有相关性。此外,对于合并焦虑、抑郁冠状动脉慢血流现象患者,氟哌噻吨美利曲辛具有良好疗效。两组焦虑抑郁患者治疗前基线资料差异无统计学意义;经治疗后,观察组GAD-7评分、PHQ-9评分均显著下降,且低于对照组(4.44±2.47 vs 12.78±3.53;4.81±2.32 vs 16.04±4.25;P均<0.05),各支冠状动脉(包括前降支、回旋支、右冠状动脉)血流速度及平均CTFC均较治疗前明显提高(P均<0.05);观察组SF-36量表各项评分(生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康等)均显著高于对照组(P均<0.05)。结论焦虑、抑郁与冠状动脉慢血流现象具有明显相关性,氟哌噻吨美利曲辛可明显缓解患者焦虑、抑郁状况,提高冠脉血流速度,改善患者生活质量,提高临床疗效。展开更多
基金This study was supported by grants from National Natural Science Foundation of China （No. 81070166） and Scientific Research Common Program of Beijing Municipal Commission of Education （No. KM201010025020）.Acknowledgement： We are grateful to all staff members of the Department of Cardiology and Catheterization Laboratory, Beijing Anzhen Hospital, Capital Medical University.
文摘Background Coronary slow flow phenomenon （CSFP） is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography （TTDE） in the diagnosis and monitoring of coronary slow flow in left anterior descending （LAD） coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction （TIMI） frame count （CTFC） was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities （DPV） and diastolic mean velocities （DMV） were calculated.Results Sixty of 65 （92.3%） subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group （（0.228±0.029） m/s vs. （0.302±0.065） m/s, P=0.000; （0.176±0.028） m/s vs. （0.226±0.052） m/s, P=0.000,respectively）. There was a high inverse correlation between CTFC and coronary DPV and DMV （r=-0.727, P=0.000;r=-0.671, P=0.000, respectively）. Receiver operating characteristic （ROC） curve showed that the area under the curve （AUC） was less than one half for coronary DPV （AUC=0.104） and DMV （AUC=0.204）, respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.
文摘In order to study the mechanism of angiographic coronary slow flow phenomenon (SF), intracoronary ultrasound (ICUS) and Doppler (ICD) were performed in 14 patients with angiographic SF phenomenon but with normal angiograms and in 16 patients with normal angiographic coronary flow (NF). A 3.5 F, 20 MHz ultrasound catheter (Boston Scientific) was used for ICUS and a 0.014 inch FloWire (Cardiometrics) was used for ICD. Coronary flow velocity including average peak velocity (APV), maximal peak velocity (MPV) at rest and at hyperemia as well as coronary flow reserve (CFR) were compared in both groups in comparison to the presence or absence of plaque formation based on ICUS. CFR in the SF group (4.2±1.1) was even higher than that of the NF group (3.1±0.6, P<0.001). Department of Cardiology, University GHS Essen, Germany (Ge JB, Simon H, Jeremias A, Liu FQ, Grge G, Haude M, Baumgart D and Erbel R) Significant differences were also found concerning the APV and MPV among both groups (both P <0.001). Plaque formation was found in 7/13 patients with a lumen reduction of 21%±24% in SF group and in 7/16 of the NF group with a lumen reduction of 19%±17%. Comparison of APV, MPV and CFR in SF and NF grups. Comparison of APV, MPV and CFR in SF and NF groups[BHDFG1*2,WK8ZQ1,WK11DW,WK11DWW] SF group NF groupAPV (cm/s) Rest 7.7±2.0 21.1±5.0 * Peak31.7±14.961.3±14.2 *MPV (cm/s) Rest17.4±4.637.0±11.4 * Peak56.8±14.981.8±17.7 *CFR4.2±1.13.1±0.6 # * P<0.001, #P=0.002. Coronary slow flow phenomenon in angiography indicates reduced resting flow velocity without reduction of coronary flow reserve.
文摘Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacifi-cation in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies,clinical manifestations and treatment of this unique angiographic phenomenon. In our case report,we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries,especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.
文摘目的探讨焦虑、抑郁状态与冠状动脉慢血流现象(coronary slow flow phenomenon,CSFP)的关系,以及氟哌噻吨美利曲辛对冠状动脉慢血流现象合并焦虑、抑郁患者的治疗效果。方法选取2015年1月-2018年8月于解放军第305医院行冠状动脉造影检查诊断为冠状动脉造影血管正常且血流正常患者120例(正常组)和冠状动脉慢血流现象患者120例(CSFP组),比较两组抑郁自评量表(PHQ-9)及焦虑自评量表(GAD-7)评分结果。进一步从冠状动脉慢血流现象组(CSFP组)筛选出合并焦虑或者抑郁患者共54例,将这些筛选出的合并焦虑、抑郁的患者按随机数字表法进一步分为对照组27例及观察组27例,对照组给予阿司匹林等常规治疗,观察组在常规治疗基础上加用氟哌噻吨美利曲辛。疗程为6个月,观察两组治疗后的临床疗效。结果与正常对照组相比,冠状动脉慢血流现象组抑郁和焦虑状态得分更高:冠状动脉慢血流现象组的GAD-7评分、PHQ-9评分均显著高于正常组(6.44±2.91 vs 4.37±2.15;7.41±2.23 vs 4.52±1.91;P均<0.05),提示焦虑、抑郁与冠状动脉慢血流现象具有相关性。此外,对于合并焦虑、抑郁冠状动脉慢血流现象患者,氟哌噻吨美利曲辛具有良好疗效。两组焦虑抑郁患者治疗前基线资料差异无统计学意义;经治疗后,观察组GAD-7评分、PHQ-9评分均显著下降,且低于对照组(4.44±2.47 vs 12.78±3.53;4.81±2.32 vs 16.04±4.25;P均<0.05),各支冠状动脉(包括前降支、回旋支、右冠状动脉)血流速度及平均CTFC均较治疗前明显提高(P均<0.05);观察组SF-36量表各项评分(生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康等)均显著高于对照组(P均<0.05)。结论焦虑、抑郁与冠状动脉慢血流现象具有明显相关性,氟哌噻吨美利曲辛可明显缓解患者焦虑、抑郁状况,提高冠脉血流速度,改善患者生活质量,提高临床疗效。
