Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon
The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by Thrombolysis in Myocardial Infarction (TIMI)-2 flow in the absence of significant large vessel coronary disease. Although clinical and pathological features have been previously described, the underlying pathophysio...
Gespeichert in:
| Veröffentlicht in: | The American heart journal 2003-07, Vol.146 (1), p.84-90 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 90 |
|---|---|
| container_issue | 1 |
| container_start_page | 84 |
| container_title | The American heart journal |
| container_volume | 146 |
| creator | Beltrame, John F Limaye, Sananand B Wuttke, Ronald D Horowitz, John D |
| description | The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by Thrombolysis in Myocardial Infarction (TIMI)-2 flow in the absence of significant large vessel coronary disease. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully elucidated. This study investigates the persistence of the phenomenon on serial angiographic studies, coronary hemodynamic findings at rest and during provocative stimuli, and biochemical evidence of inducible myocardial ischemia.
Twelve patients with CSFP underwent repeat angiography and coronary sinus canulation that allowed for the assessment of coronary blood flow, transmyocardial lactate, and oxygen extraction. Parameters were assessed at rest and during rapid atrial pacing, cold pressor stimulation, and acetylcholine infusion. Angiographic and coronary hemodynamic findings were compared with 47 patients who underwent angiography and 8 patients who were hemodynamic control subjects, respectively.
Persistent TIMI-2 flow was demonstrated with repeat angiography in only 4 of the patients. However, the corrected TIMI frame count remained delayed compared with that in control subjects. Furthermore, resting coronary sinus oxygen saturation was low compared with control subjects (23% ± 4% vs 31% ± 4%;
P |
| doi_str_mv | 10.1016/S0002-8703(03)00124-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73435584</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870303001248</els_id><sourcerecordid>73435584</sourcerecordid><originalsourceid>FETCH-LOGICAL-c485t-16e2ded93fc2159ed9f98ca715de7e61647eca22702ef995ec056630cd6b87473</originalsourceid><addsrcrecordid>eNqFkF1LHDEYhUNR6vrxE1oGpGIvpiaZfM2VlEVbQfCieh2yyTtsZCZZkxmL_74Zd1vBm0K-XnjO4eQg9IngbwQTcfELY0xrJXFzjpuvGBPKavUBLQhuZS0kY3to8Q85QIc5P5ZRUCU-ogNCFSeC0AW6W8YUg0kv1RqG6F6CGbytTHDVAKNZxb5MeZych1zFrhrXUNm_itzH31U3H5s1hDiUHY7Rfmf6DCe7-wg9XF_dL3_Wt3c_bpbfb2vLFB9rIoA6cG3TWUp4W15dq6yRhDuQIIhgEqyhVGIKXdtysJgL0WDrxEpJJpsjdLb13aT4NEEe9eCzhb43AeKUtWxYw7liBTx9Bz7GKYWSTRPOijUrgQrFt5RNMecEnd4kP5RPaoL13Ld-7VvPZep5zX1rVXSfd-7TagD3ptoVXIAvO8Bka_oumWB9fuNKgoZQXLjLLQeltGcPSWfrIVhwPoEdtYv-P1H-APiTm-c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1549954485</pqid></control><display><type>article</type><title>Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Beltrame, John F ; Limaye, Sananand B ; Wuttke, Ronald D ; Horowitz, John D</creator><creatorcontrib>Beltrame, John F ; Limaye, Sananand B ; Wuttke, Ronald D ; Horowitz, John D</creatorcontrib><description>The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by Thrombolysis in Myocardial Infarction (TIMI)-2 flow in the absence of significant large vessel coronary disease. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully elucidated. This study investigates the persistence of the phenomenon on serial angiographic studies, coronary hemodynamic findings at rest and during provocative stimuli, and biochemical evidence of inducible myocardial ischemia.
Twelve patients with CSFP underwent repeat angiography and coronary sinus canulation that allowed for the assessment of coronary blood flow, transmyocardial lactate, and oxygen extraction. Parameters were assessed at rest and during rapid atrial pacing, cold pressor stimulation, and acetylcholine infusion. Angiographic and coronary hemodynamic findings were compared with 47 patients who underwent angiography and 8 patients who were hemodynamic control subjects, respectively.
Persistent TIMI-2 flow was demonstrated with repeat angiography in only 4 of the patients. However, the corrected TIMI frame count remained delayed compared with that in control subjects. Furthermore, resting coronary sinus oxygen saturation was low compared with control subjects (23% ± 4% vs 31% ± 4%;
P <.01), reflecting an increased basal coronary vasomotor tone. The coronary vasodilatory response to atrial pacing was similar to that in control subjects; however, several patients exhibited abnormal vasomotor responsiveness to cold pressor and acetylcholine stimuli. There was no evidence of nett myocardial lactate production with atrial pacing.
The CSFP is associated with a chronically elevated resting coronary microvascular tone, even when symptoms are relatively quiescent.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/S0002-8703(03)00124-8</identifier><identifier>PMID: 12851612</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Acute coronary syndromes ; Adult ; Analysis of Variance ; Biological and medical sciences ; Cardiac Catheterization ; Cardiac Pacing, Artificial ; Cardiology. Vascular system ; Catheters ; Chest Pain - physiopathology ; Coronary Angiography ; Coronary Circulation - physiology ; Coronary heart disease ; Coronary vessels ; Heart ; Heart attacks ; Heart rate ; Hemodynamics - physiology ; Humans ; Intubation ; Ischemia ; Lactic Acid - analysis ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Myocardial Ischemia - blood ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - physiopathology ; Neuropeptides ; Oxygen - metabolism ; Pain ; Studies ; Veins & arteries</subject><ispartof>The American heart journal, 2003-07, Vol.146 (1), p.84-90</ispartof><rights>2003 Mosby, Inc.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jul 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-16e2ded93fc2159ed9f98ca715de7e61647eca22702ef995ec056630cd6b87473</citedby><cites>FETCH-LOGICAL-c485t-16e2ded93fc2159ed9f98ca715de7e61647eca22702ef995ec056630cd6b87473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870303001248$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14993120$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12851612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beltrame, John F</creatorcontrib><creatorcontrib>Limaye, Sananand B</creatorcontrib><creatorcontrib>Wuttke, Ronald D</creatorcontrib><creatorcontrib>Horowitz, John D</creatorcontrib><title>Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by Thrombolysis in Myocardial Infarction (TIMI)-2 flow in the absence of significant large vessel coronary disease. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully elucidated. This study investigates the persistence of the phenomenon on serial angiographic studies, coronary hemodynamic findings at rest and during provocative stimuli, and biochemical evidence of inducible myocardial ischemia.
Twelve patients with CSFP underwent repeat angiography and coronary sinus canulation that allowed for the assessment of coronary blood flow, transmyocardial lactate, and oxygen extraction. Parameters were assessed at rest and during rapid atrial pacing, cold pressor stimulation, and acetylcholine infusion. Angiographic and coronary hemodynamic findings were compared with 47 patients who underwent angiography and 8 patients who were hemodynamic control subjects, respectively.
Persistent TIMI-2 flow was demonstrated with repeat angiography in only 4 of the patients. However, the corrected TIMI frame count remained delayed compared with that in control subjects. Furthermore, resting coronary sinus oxygen saturation was low compared with control subjects (23% ± 4% vs 31% ± 4%;
P <.01), reflecting an increased basal coronary vasomotor tone. The coronary vasodilatory response to atrial pacing was similar to that in control subjects; however, several patients exhibited abnormal vasomotor responsiveness to cold pressor and acetylcholine stimuli. There was no evidence of nett myocardial lactate production with atrial pacing.
The CSFP is associated with a chronically elevated resting coronary microvascular tone, even when symptoms are relatively quiescent.</description><subject>Acute coronary syndromes</subject><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization</subject><subject>Cardiac Pacing, Artificial</subject><subject>Cardiology. Vascular system</subject><subject>Catheters</subject><subject>Chest Pain - physiopathology</subject><subject>Coronary Angiography</subject><subject>Coronary Circulation - physiology</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart rate</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Intubation</subject><subject>Ischemia</subject><subject>Lactic Acid - analysis</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - blood</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocardial Ischemia - physiopathology</subject><subject>Neuropeptides</subject><subject>Oxygen - metabolism</subject><subject>Pain</subject><subject>Studies</subject><subject>Veins & arteries</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkF1LHDEYhUNR6vrxE1oGpGIvpiaZfM2VlEVbQfCieh2yyTtsZCZZkxmL_74Zd1vBm0K-XnjO4eQg9IngbwQTcfELY0xrJXFzjpuvGBPKavUBLQhuZS0kY3to8Q85QIc5P5ZRUCU-ogNCFSeC0AW6W8YUg0kv1RqG6F6CGbytTHDVAKNZxb5MeZych1zFrhrXUNm_itzH31U3H5s1hDiUHY7Rfmf6DCe7-wg9XF_dL3_Wt3c_bpbfb2vLFB9rIoA6cG3TWUp4W15dq6yRhDuQIIhgEqyhVGIKXdtysJgL0WDrxEpJJpsjdLb13aT4NEEe9eCzhb43AeKUtWxYw7liBTx9Bz7GKYWSTRPOijUrgQrFt5RNMecEnd4kP5RPaoL13Ld-7VvPZep5zX1rVXSfd-7TagD3ptoVXIAvO8Bka_oumWB9fuNKgoZQXLjLLQeltGcPSWfrIVhwPoEdtYv-P1H-APiTm-c</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>Beltrame, John F</creator><creator>Limaye, Sananand B</creator><creator>Wuttke, Ronald D</creator><creator>Horowitz, John D</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20030701</creationdate><title>Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon</title><author>Beltrame, John F ; Limaye, Sananand B ; Wuttke, Ronald D ; Horowitz, John D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-16e2ded93fc2159ed9f98ca715de7e61647eca22702ef995ec056630cd6b87473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Acute coronary syndromes</topic><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization</topic><topic>Cardiac Pacing, Artificial</topic><topic>Cardiology. Vascular system</topic><topic>Catheters</topic><topic>Chest Pain - physiopathology</topic><topic>Coronary Angiography</topic><topic>Coronary Circulation - physiology</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart rate</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Intubation</topic><topic>Ischemia</topic><topic>Lactic Acid - analysis</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - blood</topic><topic>Myocardial Ischemia - diagnostic imaging</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Neuropeptides</topic><topic>Oxygen - metabolism</topic><topic>Pain</topic><topic>Studies</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beltrame, John F</creatorcontrib><creatorcontrib>Limaye, Sananand B</creatorcontrib><creatorcontrib>Wuttke, Ronald D</creatorcontrib><creatorcontrib>Horowitz, John D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beltrame, John F</au><au>Limaye, Sananand B</au><au>Wuttke, Ronald D</au><au>Horowitz, John D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>146</volume><issue>1</issue><spage>84</spage><epage>90</epage><pages>84-90</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by Thrombolysis in Myocardial Infarction (TIMI)-2 flow in the absence of significant large vessel coronary disease. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully elucidated. This study investigates the persistence of the phenomenon on serial angiographic studies, coronary hemodynamic findings at rest and during provocative stimuli, and biochemical evidence of inducible myocardial ischemia.
Twelve patients with CSFP underwent repeat angiography and coronary sinus canulation that allowed for the assessment of coronary blood flow, transmyocardial lactate, and oxygen extraction. Parameters were assessed at rest and during rapid atrial pacing, cold pressor stimulation, and acetylcholine infusion. Angiographic and coronary hemodynamic findings were compared with 47 patients who underwent angiography and 8 patients who were hemodynamic control subjects, respectively.
Persistent TIMI-2 flow was demonstrated with repeat angiography in only 4 of the patients. However, the corrected TIMI frame count remained delayed compared with that in control subjects. Furthermore, resting coronary sinus oxygen saturation was low compared with control subjects (23% ± 4% vs 31% ± 4%;
P <.01), reflecting an increased basal coronary vasomotor tone. The coronary vasodilatory response to atrial pacing was similar to that in control subjects; however, several patients exhibited abnormal vasomotor responsiveness to cold pressor and acetylcholine stimuli. There was no evidence of nett myocardial lactate production with atrial pacing.
The CSFP is associated with a chronically elevated resting coronary microvascular tone, even when symptoms are relatively quiescent.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>12851612</pmid><doi>10.1016/S0002-8703(03)00124-8</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8703 |
| ispartof | The American heart journal, 2003-07, Vol.146 (1), p.84-90 |
| issn | 0002-8703 1097-6744 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73435584 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute coronary syndromes Adult Analysis of Variance Biological and medical sciences Cardiac Catheterization Cardiac Pacing, Artificial Cardiology. Vascular system Catheters Chest Pain - physiopathology Coronary Angiography Coronary Circulation - physiology Coronary heart disease Coronary vessels Heart Heart attacks Heart rate Hemodynamics - physiology Humans Intubation Ischemia Lactic Acid - analysis Male Medical imaging Medical sciences Middle Aged Myocardial Ischemia - blood Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - physiopathology Neuropeptides Oxygen - metabolism Pain Studies Veins & arteries |
| title | Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T16%3A14%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Coronary%20hemodynamic%20and%20metabolic%20studies%20of%20the%20coronary%20slow%20flow%20phenomenon&rft.jtitle=The%20American%20heart%20journal&rft.au=Beltrame,%20John%20F&rft.date=2003-07-01&rft.volume=146&rft.issue=1&rft.spage=84&rft.epage=90&rft.pages=84-90&rft.issn=0002-8703&rft.eissn=1097-6744&rft.coden=AHJOA2&rft_id=info:doi/10.1016/S0002-8703(03)00124-8&rft_dat=%3Cproquest_cross%3E73435584%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1549954485&rft_id=info:pmid/12851612&rft_els_id=S0002870303001248&rfr_iscdi=true |