Non Invasive Predictors of Coronary Slow Flow

Background:The coronary slow flow phenomenon (CSFP) is an angiographic clinical entity, characterized by delayed distal vessel opacification in the absence of significant epicardial coronary stenosis. The pathogenic mechanisms are incompletely understood. It has direct clinical implications, being linked to clinical manifestations of myocardial ischemia, life-threatening arrhythmias, sudden cardiac death, and recurrent acute coronary syndrome.Aim of the work: To evaluate the role of non-invasive measures in predicting Primary coronary slow flow patients.Patients and methods: Our study was a case control study, taking patients referred for cardiac catheterization for suspected coronary artery disease. We took two groups 50 patients each.Group I: primary coronary slow flow phenomenon. Group II: normal coronary angiography. All patients were subjected to thorough clinical examination and full lab including lipid panel, hsCRP and Troponin, ECG where PWD and QTc dispersion were measured, TTE including coronary flow velocities (Diastolic and systolic) and DSPVR (Diastolic and systolic peak velocity ratio) as well as assessment of TIMI frame counts.Results: The independent factors predicting PCSF among the examined groups, included diabetes, P wave dispersion ≥ 60 msec, QT dispersion ≥ 60 msec, HCT (hemataocrit) level ≥ 40 % and hs CRP ≥ 4 mg/L and DSPVR ≤ 1.6. A score was done for the independent variables using the prediction equation for multiple regression. Patients with scores > 12 are more likely to have PCSF (P=0.000).Conclusion: PCSF is associated with diabetes, greater PWD and QTc dispersion, higher HCT and hsCRP levels.