Defining Coronary Slow Flow

Henein, Michael Y.; Vancheri, Federico

doi:10.1177/00033197211007702

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…The pathogenesis of CSF still is not clear, and it is mostly considered to be related to coronary atherosclerosis, endothelial dysfunction, chronic inflammatory response, oxidative stress response, microvascular dysfunction, and abnormal platelet function ( Li et al, 2019 ; Henein and Vancheri, 2021 ; Zhu and Su, 2021 ). SXBXP is a modified formula of Su He Xiang Pill derived from Taiping Huimin Heji Ju Fang in the Song Dynasty and it is indicated for the chest painful impediment syndrome with pattern of Qi stagnation and blood stasis.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow

Guo

Zhu

2022

Front. Pharmacol.

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Background: Coronary slow flow (CSF) is a common cardiovascular phenomenon with no effective treatment in conventional Western medicine (CWM). Shexiang Baoxin Pill (SXBXP) is a widely used Chinese medicine for cardiovascular disease in China, and clinical studies have shown that it has good efficacy for CSF.Objective: To systematically evaluate the efficacy and safety of SXBXP for CSF.Methods: Seven databases were searched to identify related randomized controlled trials (RCTs). The Meta-analysis, trial sequential analysis (TSA), and Grades of Recommendation, Assessment, Development and Evaluation (GRADE) were performed using Stata 14.1, TSA 0.9.5.10 Beta and GRADE profiler 3.2.2 software respectively.Results: A total of 10 RCTs were included. Meta-analysis showed that compared with CWM treatment alone, SXBXP combined with CWM further improved the angina pectoris efficacy [RR = 1.37, 95% CI (1.23, 1.52), p < 0.000 01] and nitric oxide (NO) level [WMD = 11.32, 95% CI (0.04, 22.59), p = 0.049], decreased the mean corrected TIMI frame count (CTFC) [WMD = −4.23, 95% CI (−5.51, −2.95), p < 0.000 01], CTFC of the left anterior descending artery (LAD) [WMD = −6.36, 95% CI (−12.07, −0.65), p = 0.029], left circumflex artery (LCX) [WMD = -5.73, 95% CI (−8.79, −2.67), p < 0.000 01], and right coronary artery (RCA) [WMD = −6.72, 95% CI (−10.60, −2.84), p = 0.001], decreased the positive rate of treadmill exercise test [RR = 0.45, 95% CI (0.25, 0.83), p = 0.010], endothelin-1 (ET-1) level [WMD = -11.03, 95% CI (−13.92, −8.14), p < 0.000 01], high-sensitivity C-reactive protein (hs-CRP) [WMD = −1.95, 95% CI (−2.57, −1.34), p < 0.000 01], and adverse reactions [RR = 0.20, 95% CI (0.05, 0.85), p = 0.030]. The GRADE evidence quality rating presented with moderate, low or very low quality of evidence. TSA further affirmed the clinical efficacy.Conclusion: Although some results suggest that there may be a positive effect of SXBXP for CSF, the quality of the primary study including the reporting is too poor and therefore, no benefits could be demonstrated. More high-quality studies are still needed to further confirm the efficacy and safety.Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022329469).

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Section: Discussionmentioning

confidence: 99%

Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow

Guo

Zhu

2022

Front. Pharmacol.

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“…The CSF was defined as a corrected coronary frame rate (CFR) >27 or requiring ≥3 beats for opacification of the coronary artery [8, 9]. Apart from the change in corrected frame count, we identified the arteries with CSF and compared the CSF status between the first and second angiographies and then created 3 groups according to the change in CSF status by applying slow flow criteria for each coronary artery [1].…”

Section: Methodsmentioning

confidence: 99%

Long-Term Change in Flow Rates in Patients with Coronary Slow Flow

Ipek,

Kamber,

Yilmaz

et al. 2023

Cardiology

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Introduction: Coronary slow flow (CSF) is a condition characterized by impaired blood flow rates in the coronary arteries. It can result in severe cardiovascular outcomes. There is no sufficient evidence regarding the certain etiology and reversibility of slow flow patterns and changes in frame counts with long-term management. Methods: We retrospectively enrolled 48 patients with chronic coronary syndrome and CSF who underwent a second angiography. A corrected coronary frame rate (CFR) >27 was defined as CSF. We created 3 groups according to the change in CSF status as the improved, not changed, and worsened groups. We compared the CFR and CSF status of the patients between the first and second angiographies within a median of 2.6 years. Results: We determined a nonsignificant change in cCFR in left anterior descending (LAD) artery (34.4 [18.9] vs. 31.59 [10.3], p = 0.35), circumflex (Cx) artery (42.84 [12.56] vs. 40.66 [13.2], p = 0.35), and right coronary artery (RCA) (57.80 [30.13] vs. 50.32 [19.5], p = 0.11). In the comparison of CSF status of LAD (75% vs. 63%, p = 0.27), Cx (96% vs. 83%, p = 0.09), RCA (94% vs. 94%, p = 1.0) between first and second angiographies, there was no significant change. In the comparison of the 3 groups according to the improvement of CSF status, there was no significant difference in demographic features, change in laboratory parameters, and time between the groups. Conclusion: There was no significant change in the median CFR and CSF status in the overall group between the two angiographies after 3 years.

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“…This phenomenon of coronary angiography is commonly referred to as primary coronary slow flow (CSF) phenomenon. It has been considered a specific disease entity, however, whether it should be considered a specific coronary syndrome or a stage in the development of coronary microvascular dysfunction remains undefined [ 1 , 2 ]. CSF was first proposed by Tambe et al [ 3 ] in 1972, and its diagnosis was based on the results of coronary angiography.…”

Section: Introductionmentioning

confidence: 99%

Relationship between quantitative epicardial adipose tissue based on coronary computed tomography angiography and coronary slow flow

Tong,

Bei,

Zhang

et al. 2023

BMC Cardiovasc Disord

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Background The purpose of this study was to explore the relationship between quantitative epicardial adipose tissue (EAT) based on coronary computed tomography angiography (CCTA) and coronary slow flow (CSF). Methods A total of 85 patients with < 40% coronary stenosis on diagnostic coronary angiography were included in this retrospective study between January 2020 and December 2021. A semi-automatic method was developed for EAT quantification on CCTA images. According to the thrombolysis in myocardial infarction flow grade, the patients were divided into CSF group (n = 39) and normal coronary flow group (n = 46). Multivariate logistic regression was used to explore the relationship between EAT and CSF. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of EAT in CSF. Results EAT volume in the CSF group was significantly higher than that of the normal coronary flow group (128.83± 21.59 mL vs. 101.87± 18.56 mL, P < 0.001). There was no significant difference in epicardial fat attenuation index between the two groups (P > 0.05). Multivariate logistic regression analysis showed that EAT volume was independently related to CSF [odds ratio (OR) = 4.82, 95% confidence interval (CI): 3.06–7.27, P < 0.001]. The area under ROC curve for EAT volume in identifying CSF was 0.86 (95% CI: 0.77–0.95). The optimal cutoff value of 118.46 mL yielded a sensitivity of 0.80 and a specificity of 0.94. Conclusions Increased EAT volume based on CCTA is strongly associated with CSF. This preliminary finding paves the way for future and larger studies aimed to definitively recognize the diagnostic value of EAT in CSF.

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Defining Coronary Slow Flow

Cited by 4 publications

References 39 publications

Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow

Meta-analysis and trial sequential analysis of shexiang baoxin pill for coronary slow flow

Long-Term Change in Flow Rates in Patients with Coronary Slow Flow

Relationship between quantitative epicardial adipose tissue based on coronary computed tomography angiography and coronary slow flow

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