A Comparative Study of Coronary Sinus Flow in Normal Healthy Controls with that of Patients of ST Segment Elevation Myocardial Infarction and Significant Coronary Artery Disease by Transthoracic Echocardiography. Is there any Gender Difference?

Objectives: The objective of the study is to estimate the coronary sinus flow in patients of ST segment elevation myocardial infarction with significant stenosis of coronary arteries, using transthoracic echocardiography (TTE) is our study’s main objective; to compare with normal healthy controls without any risk factors and coronary artery disease (CAD); and to see any gender differences in this study. Materials and Methods: This was a case–control, retrospective study, done in subjects referred to MKCG MC and Hospital, Department of CAardiology, over a 2-month period. Cases were 50 numbers of ST-segment elevation myocardial infarction (STEMI) patients and controls were 50 healthy subjects without any risk factors (diabetes mellitus, hypertension, dyslipidemia, smoking, alcohol, and family history of CAD) and CAD. In each study participant, left ventricular ejection fraction (LVEF), coronary sinus diameter (CSD), coronary sinus flow (CSF), and coronary sinus velocity time integral (CSVTI) were calculated using TTE. Results: In STEMI patients, there was significantly lower coronary sinus flow than controls. CSF in cases was 3.18 mL whereas 11.78 mL in healthy controls ( P < 0.05). CSVTI and CSD were also significantly lower in cases than in controls ( P < 0.05). The cut-off value 6.4 mL of CSF was 99% sensitive and 98% specific for diagnosing STEMI patients of significant stenosis from that of healthy subjects, which was calculated by receiver operating characteristic analysis. The CSF/min, CSF, and CSVTI when compared between males and females in cases and controls by applying an independent t -test did not show any statistical significance, although CSF and CSF/min were little higher in the female cases and controls. Conclusion: Coronary sinus blood flow measurement by TTE is a simple, earliest, accurate factor for diagnosing STEMI patients with significant coronary stenosis than healthy subjects. There is no significant difference in CSF between males and females in the present study.