Early repolarization pattern in the coronary slow flow phenomenon

Sucu, Murat; Uçaman, Berzal; Altunbaş, Gökhan

doi:10.1080/14017431.2018.1430372

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Patients with CSF experience unexplained recurrent chest pain symptoms (7)(8)(9). Myocardial ischemia and acute coronary syndrome can occur in patients with severe CSF (10,11), which results in a higher incidence of sudden death caused by acute myocardial infarction and ventricular arrhythmia among these patients (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

2021

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Background: To explore the relationship between coronary slow flow (CSF) and both matrix metalloproteinase-9 (MMP-9) and soluble cluster of differentiation 40 ligand (sCD40L).Methods: Between July 2016 and September 2019, 80 patients suspected of having coronary heart disease due to chest tightness or other symptoms of chest pain and discomfort were admitted to Nanjing Jiangbei People's Hospital and, following a coronary angiography, were diagnosed as having CSF. These patients were assigned to the coronary slow flow phenomenon (CSFP) group. The control group, or normal coronary flow (NCF) group, consisted of 80 patients with normal coronary angiography results. Following group assignment, enzyme-linked immunosorbent assays (ELISAs) were used to measure and compare the serum levels of sCD40L and MMP-9 between the two groups.Results: Serum levels of sCD40L and MMP-9 in the CSFP group were significantly higher than those in the NCF group (P<0.05). Additionally, serum levels of adhesion molecules and C-reactive protein (CRP) in the CSFP group were significantly higher than those in NCF group (P<0.05). There was a positive correlation observed between sCD40L levels and adhesion molecule levels in the CSFP group, however, there was no such correlation observed in the NCF group. The CSFP group also had a significantly higher corrected TIMI frame count (CTFC) compared with the NCF group (P<0.05).Conclusions: Serum MMP-9 levels were higher in patients with CSF, and MMP-9 levels were positively correlated with CTFC. This suggests that chronic inflammation may play a role in CSF pathogenesis and that atherosclerotic plaques may be present in the coronary arteries of CSF patients. Additionally, serum levels of sCD40L, adhesion molecules, and CRP were higher in CSF patients, and CRP levels were positively correlated with CTFC. Adhesion molecule expression is promoted by sCD40L. Increased levels of sCD40L may therefore promote the development of CSF.

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Section: Introductionmentioning

confidence: 99%

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

2021

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“…17 Sucu M et al 18 in a study reported an association between the J-wave and slurring early repolarization pattern with coronary slow flow phenomenon among patients with positive responses to treadmill testing or chest pain indicative of "stable angina" pectoris. In a different investigation conducted by Kitamura T and colleagues, 19 it was observed that the existence of early repolarization patterns, particularly when they exhibit day-to-day fluctuations, can serve as a valuable predictor for the recurrence of ventricular fibrillation (VF) in individuals with vasospastic angina (VSA). Consequently, for the secondary prevention of VF in high-risk VSA patients, the implantation of an "implantable cardioverter defibrillator (ICD)" is considered a reasonable strategy.…”

Section: Discussionmentioning

confidence: 99%

Frequency and Factors Associated with Early Repolarization Changes in ECG in Patients Presenting With Chest Pain

Anoshi,

Zada,

Khan

et al. 2023

Pak Heart J

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Objectives: The “early repolarization (ER)” pattern, previously regarded as benign, has recently shown associations with adverse outcomes, including all-cause, arrhythmic and cardiac mortality. This study aimed to assess the prevalence and factors linked to ER changes in the ECG among chest pain patients at a tertiary cardiac center. Methodology: We enrolled 271 patients aged 18-80 with chest pain complaints. Baseline 12-lead ECGs were used to assess the ER pattern. Multivariable binary logistic regression was conducted, and “odds ratios (OR)” with 95% “confidence intervals (CI)” were reported. Results: Of the 271 patients, 162 (59.8%) were male, with a mean age of 55.3 ± 10 years, and 40 (14.8%) were ≤45 years old. The ER pattern was present in 92 (33.9%) patients. The ER pattern was associated with low “body mass index (BMI)” (OR=0.85 [95% CI: 0.77 - 0.94; p=0.002]), shorter T-wave duration (OR=0.99 [95% CI: 0.98 - 1.00; p=0.008]), and lower heart rate (OR=0.94 [95% CI: 0.90 - 0.98; p=0.007]). Additionally, the odds of ER pattern were lower in patients with “ST-elevation myocardial infarction (STEMI)” (OR=0.23 [95% CI: 0.07 - 0.72; p=0.012]) and non-STEMI (OR=0.21 [95% CI: 0.07 - 0.63; p=0.006]) compared to non-cardiac chest pain. Conclusion: Early repolarization is a common ECG pattern in one-third of chest pain patients. Associated factors include low BMI, shorter T-wave duration, and lower heart rate, and it is less frequent in patients with STEMI and non-STEMI.

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“…CSF refers to a phenomenon whereby normal or nearnormal major branches of the coronary arteries are observed on coronary angiography but there is delayed blood flow in distal blood vessel upon imaging [2][3][4]. ere is now substantial evidence demonstrating that CSF is a main cause of clinical cardiovascular events such as resting and exertional angina and even myocardial infarction [2,[23][24][25], which severely affect quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…is phenomenon is termed coronary slow flow (CSF), which refers to normal or nearnormal major branches in the coronary arteries on coronary angiography but delayed and slow distal blood flow in vessel imaging [2][3][4]. CSF has been increasingly recognized with the popularization of coronary angiography, and it occurs in approximately 7% of patients with suspected coronary heart disease [5].…”

Section: Introductionmentioning

confidence: 99%

miRNA-22 as a Candidate Diagnostic Biomarker for Coronary Slow Flow

Chen

Wang

2020

Cardiology Research and Practice

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Background. Coronary slow flow (CSF) refers to the phenomenon of delayed distal flow in the absence of lesions detected on coronary angiography. Although the detection rate of CSF has been increasing in clinical practice, early diagnosis is difficult and the factors contributing to this condition remain unclear. Given the increasing demonstration of the roles of microRNAs (miRNAs) in disease and as diagnostic biomarkers, the aim of this study was to analyze the expression of serum miRNA-22 in patients with CSF detected using coronary angiography and its diagnostic efficacy. Methods and Results. A retrospective analysis including 44 patients with CSF and 42 patients with normal coronary flow (control group) was conducted. Additionally, all included patients either did not have visually estimated coronary artery stenosis or had <50% stenosis. Plasma samples were collected from patients in these two groups, and the levels of miRNA-22 were detected. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency of serum miRNA-22 in the context of CSF. Results. The expression of serum miRNA-22 was significantly higher in the CSF patients than in the control subjects (P < 0.0001). The area under the ROC curve for miRNA-22 in diagnosing CSF was 0.8293 (95% confidence interval: 0.7313–0.9272), with a sensitivity of 75.0% and specificity of 88.1%. Conclusions. The expression of serum miRNA-22 in CSF is upregulated compared to that in subjects with normal coronary flow and shows relatively high clinical diagnostic efficiency, suggesting a new potential biomarker for the early diagnosis of CSF.

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Early repolarization pattern in the coronary slow flow phenomenon

Abstract: We report that CSFP is associated with J-wave and slurring ERPs. However, the clinical significance of these changes needs to be clarified.

Cited by 4 publications

References 18 publications

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

A preliminary study of MMP-9 and sCD40L in patients with coronary slow flow

Frequency and Factors Associated with Early Repolarization Changes in ECG in Patients Presenting With Chest Pain

miRNA-22 as a Candidate Diagnostic Biomarker for Coronary Slow Flow

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