| Objective:To analyze the risk factors and pathogenesis of patients with coronary slow flow(CSF); To evaluate the clinical features and risks of patients with CSF.Methods:236(1.36%) patients with CSF screening out from17,390patients with coronary angiography by TIMI flow grade method in TEDA hospital from January2006to December2010and240control subjects (40-50cases every year) with normal coronary flow were included. All subjects had normal coronary arteries angiography. The clinical data were obtained from medical records at admission and the laboratory data were measured on an empty stomach in the early morning of second day. SPSS11.5software was used for the statistical analysis. Multinomial logistic regression analysis was used on the risk factors of CSF with P<0.05as the significant difference statistically. The clinical features, results of Echocardiogram and Holter of patients with CSF were statistical analyzed. The cardiovascular events (myocardial infarction, ventricular tachycardia, syncope) were recorded to evaluate the clinical risk of patients with CSF.Results:(1). CSF group was compared with control group, the ratio of gender (male/female:181/236vs101/139), smoking rate (58.48%vs27.5%) and creatinine value (68.28±15.07vs60.92±13.17umol) were significantly higher (p<0.01); Body mass index (26.78±3.75vs26.13±3.20), uric acid value (345.2±86.12vs304.43±76.44umol) and serum triglyceride value (1.85±1.23vs1.65±0.81mmol/L) were higher (P<0.05); High density lipoprotein value (1.14±0.28vs1.19±0.30mmol/L) was lower (P<0.05). By using multinomial logistic regression analysis, the results were that gender (OR=4.959P=0.000), smoking (OR=2.022P=0.005), body mass index (OR=1.373P=0.038), uric acid (OR=1.857P=0.007) were the independent risk factors of the patients with CSF.(2).75%(177/236) patients with CSF had chest pains,55%(130/236) patients with CSF had abnormal movements of local ventricular wall checked by echo cardiograph. One patient with CSF was myocardial infarction.30%(72/236) patients with CSF had symptoms of arrhythmia.130patients with CSF were checked by Holter ECG. The type of arrhythmia was that:70(53.85%) cases were ventricular or atrial premature beats,37(28.46%) cases were atrial fibrillations,15(11.53%) cases were paroxysmal atrial tachycardias,5(3.85%) cases were non-sustained ventricular tachycardias,3(2.31%) cases were paroxysmal supraventricular tachycardias. Two patients of non-sustained ventricular tachycardia had symptom of syncope, one of which was implanted ICD due to repeated syncope.Conclusions1. Gender, smoking, body mass index and serum uric acid are the independent risk factors of patients with CSF. And these conventional risk factors of coronary heart disease:high blood pressure, diabetes mellitus, hyperlipidemia are no obvious correlation with CSF. Therefore, smoking cessation, weight control, and low purine diet help to reduce the occurrence of CSF. The pathogenesis of CSF may be a combinational result of many factors.2. Patients with CSF often have the symptoms of chest pains, more are atypical angina symptoms, resting pains not associated with fatigue. Patients with CSF also have the symptoms of arrhythmia. Types of arrhythmia are ventricular or atrial premature beat, atrial fibrillation, non-sustained ventricular tachycardia. CSF may lead to even myocardial infarction or syncope by ventricular tachycardia, that are malignant cardiovascular events. So patients with CSF have potential clinical risks, clinical physician should pay high attentions to them. |
PDF Full Text Request