Coronary slow flow: Benign or ominous?

Abstract

Objective:Coronary slow flow phenomenon has been arbitrarily defined as delayed coronary blood flow in the absence of obstructive coronary artery disease. The present study sought to investigate the clinical features, natural history, and outcomes of affected patients.Methods:In this prospective cross-sectional study, 217 consecutive patients who had undergone coronary angiography and showed features of coronary slow flow phenomenon were evaluated for demographic and coronary risk factor profile, as well as clinical outcomes, at baseline and following treatment.Results:The study population consisted of 165 (76%) males and 52 (24%) females. The mean age of patients was 52.6±10 years. Mean ejection fraction was 48.2±5.4, 39.3% had diabetes, 43.3% had hypertension, 49.8% was a cigarette smoker, 41.9% had dyslipidemia, and 15% had a familial history of cardiac disease. Forty-nine percent was detected to have abnormal hsCRP levels. The most prevalent presenting complaint was atypical chest pain. Fifty-four percent of patients had slow blood flow in all three vessels. Thirty-six people had undergone repeat coronary angiography in a follow-up period of 5-7 years due to persisting or worsening clinical symptoms, of whom 6 (16.6%) showed significant coronary artery stenosis. Eight (22.2%) had mild CAD, and the rest still showed coronary slow flow without significant stenosis. The most common complaint during follow-up and after initiation of medical therapy was nonanginal chest pain.Conclusion:Patients with coronary slow flow phenomenon are predisposed to atherosclerosis and obstructive coronary artery disease. Therefore, this pathology should not be considered as a totally benign condition. Primary and secondary cardiovasculature preventive measures should be constituted and seem worthwhile in this patient population.

Clinical Profile and Outcome in Patients with Coronary Slow Flow Phenomenon

“…Little is known about the prognosis of true primary CSFP, because the most published literature has included patients with known heart failure, near-normal coronary arteries (<40% stenosis), and other unexplained diseases [12, 13], and as a result, their outcome was not substantially the same as that observed in this study. In this study, we have tried to exclude patients with a possible secondary form of CSFP and other disease states as has been said before by sticking to very strict inclusion and exclusion criteria.…”

Determinação do Tecido Cicatricial do Miocárdio no Fenômeno de Fluxo Coronário Lento e a Relação entre a Quantidade de Tecido Cicatricial e o Nt-ProBNP

“…A função microvascular coronária deteriorada no FCL demonstrou uma relação com o aumento do risco de eventos cardiovasculares. [25][26][27] Além disso, foi relatado que, nos pacientes com disfunção microvascular, o prognóstico é semelhante àquele observado na doença arterial coronariana obstrutiva, e que essa disfunção não é tão benigna quanto se pensava. [28][29][30] As manifestações clínicas dessa patologia também estão associadas a achados significativos.…”

Anxiety and depression relationship with coronary slow flow

“…These are traditional CAD risk factors which supports the theory of subclinical atherosclerosis role in CSF pathogenesis (involving increased sympathetic activity, inflammatory response, endothelial dysfunction, abnormal platelet activation and release of its products). [4] However, previous studies examining this association showed conflicting results: male gender and high TG levels were significant independent predictors of CSF in some studies,[18,19] while others found no relationship between gender and CSF. [20] As for high TG, the present study is consistent with previous one by Dai YX et al, who reported that patients with high levels of TG (in addition to high fasting blood glucose and low levels of HDL) were more likely to have CSF.…”