Assessment The Risk Factors Of Coronary Slow Flow And Its Effect On Left Ventricular Function

Objectives:To investigate the risk factors associated with slow flow of coronary artery and to evaluate the left ventricular function in patients with slow coronary artery flow,and to determine the effect of slow coronary artery flow on left ventricular function.Methods:Collecting 166 patients with no obvious stenosis of coronary artery in the Department of Cardiology of the Second Affiliated Hospital of Kunming Medical University from January,2015 to January,2018.According to TIMI blood flow classification and corrected TIMI frame counting method,these patients were divided into two groups,the slow flow group(104 cases)and the normal blood flow group(62 cases).The clinical data of two groups were collected,such as general information(sex,age),past history(smoking history,hypertension history,diabetes history,obstructive sleep apnea hypopnea syndrome(OSAHS),et al),body mass index(BMI),laboratory index(blood cell count,blood biochemistry,et al).Logistic regression was used to analyze the risk factors for slow flow of coronary artery.The left ventricular systolic and diastolic function of patients with slow blood flow were assessed by conventional ultrasound and doppler ultrasound.Results:l.The sex ratio(69.23%vs 43.55%,P=0.001),combined with OSAHS disease(75%vs 20.97%,P<0.001),the positive rate of smoking history(55.77%vs 37.10%,P=0.020),BMI(25.72 + 3.33 vs 23.42 + 3.50,P<0.001),uric acid(443.03 +90.82 vs 357.65 + 87.763,P<0.05),homocysteine The concentration of hemoglobin(151.06 + 15.8 vs 145.35 + 19.43,p=0.041),platelet count(223.22 + 61.97 vs 199.89+ 51.40,p=0.014)and platelets distribution width(14.338 + 4.38 vs 12.99 + 2.57,p=0.028)were significantly higher in the coronary flow group than in the nomal coronary flow group;2.Early diastolic peak velocity of mitral valve in patients with slow flow(0.75 + 0.19 vs 0.81 + 0.20,p=0.041)and Early diastolic mitral inflow velocity/Late diastolic mitral inflow velocity(0.90 + 0.28 vs 1.09 + 0.36,p=0.001),which was significantly lower than that of normal blood flow group:3.This study shows that single vessel involvement is the most common in patients with coronary slow flow,and there are three or two vessels involved simultaneously.The most frequently involved vessels are LAD,accounting for 55.77%of the slow flow group;4.Multifactor Logistic regression analysis showed that OSAHS(OR 7.169,95%CI 2.52-20.348,P<0.001),hyperuricemia(OR 1.009,95%CI 1.002 to 1.015,P=0.009),hyperhomocysteinemia(OR 1.294,95%CI 1.333 -1.781,P<0.001)may be a risk factor for CSF;5.The correlation analysis between the frame number of coronary artery blood flow and E and E/A showed that the number of LAD frames in the anterior descending branch,the number of corrected anterior descending blood flow frames(cLAD),mTFC and E/A were negatively correlated.Conclusion(s):Smoking,BMI,platelet count,hemoglobin concentrationand platelet distribution width may affect the pathophysiological process of coronary slow flow.Obstructive sleep apnea hypopnea syndrome,hyperuricemia,hyperhomocysteinemia may be a risk factor for slow coronary artery blood flow.Left ventricular diastolic function may be impaired in patients with slow coronary flow,but early systolic function impairment is not obvious.