Slow coronary flow was significantly associated with adverse electrical, structural, metabolic, and circadian blood pressure abnormalities compared to normal coronary flow.
Case-Control (n=70)
Are there differences in clinical, electrical, structural, and hemodynamic parameters between patients with slow coronary flow and normal coronary flow?
Coronary slow flow phenomenon is associated with diffuse electrical, structural, metabolic, and circadian blood pressure abnormalities, suggesting it is a diffuse microvascular disorder rather than a benign angiographic variant.
ABSTRACT Background: Coronary slow flow (CSF) phenomenon is characterized by delayed distal coronary opacification despite angiographically normal or near-normal coronary arteries. CSF phenomenon is increasingly recognized as a cause of angina, myocardial ischemia, malignant arrhythmias, and sudden cardiac death, yet its pathophysiology and optimal management remain poorly defined. Does the CSF phenomenon represent an incidental angiographic curiosity or an underrecognized entity with important clinical implications? Aim and Objectives: The study aimed to compare clinical characteristics, electrocardiographic, echocardiographic, biochemical, ambulatory blood pressure monitoring (ABPM), and angiographic parameters between patients with slow coronary flow (SCF) and normal coronary flow (NCF). Materials and Methods: This case–control study included 70 patients undergoing coronary angiography: 35 with SCF and 35 with NCF. Coronary flow was quantified using the TIMI frame count. All patients underwent ECG, transthoracic echocardiography, laboratory evaluation, and 24-h ABPM. Comparisons were performed using appropriate parametric and nonparametric statistical tests. Results: Patients with SCF had significantly higher prevalence of diabetes mellitus, dyslipidemia, increased body mass index, and body surface area. ECG analysis showed significantly higher rates of left ventricular (LV) hypertrophy, ST-segment depression, prolonged QT and corrected QT intervals, increased QT dispersion, Tp–Te interval, and Tp–Te/QT ratio in the SCF group. Echocardiography revealed significantly increased LV end-diastolic diameter, interventricular septal thickness, posterior wall thickness, LV mass, LV mass index, and left atrial size in SCF patients, while LV systolic function was preserved. Biochemically, SCF patients had significantly higher total cholesterol, triglycerides, and low-density lipoprotein levels. ABPM demonstrated significantly higher 24-h pulse pressure and heart rate in SCF patients, with higher daytime pulse pressure and nocturnal systolic blood pressure. Nondipping and reverse-dipping blood pressure patterns were significantly more prevalent in the SCF group. TIMI frame counts were significantly elevated in all major coronary arteries in SCF patients. Conclusion: CSFP is associated with adverse electrical, structural, metabolic, and circadian blood pressure abnormalities despite preserved systolic function. These findings support the concept of CSFP as a diffuse microvascular and endothelial disorder rather than a benign angiographic variant.
Sheikh et al. (Wed,) conducted a case-control in Coronary slow flow phenomenon (n=70). Slow coronary flow vs. Normal coronary flow was evaluated on Clinical, electrocardiographic, echocardiographic, biochemical, ABPM, and angiographic parameters. Slow coronary flow was significantly associated with adverse electrical, structural, metabolic, and circadian blood pressure abnormalities compared to normal coronary flow.