Vascular endothelial function in patients with slow coronary flow

Background Slow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear. Design The aim of the study was to determine endothelial function in patients with SCF using a flow-mediated dilatation (FMD) technique in the brachial artery. Methods Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count (CTFC) method. Endothelial function was studied in 27 patients with SCF (23 men, four women, mean age 476 8.7 years) and in 30 people with normal coronary flow (NCF) (22 men and eight women, mean age 475 74 years). Results The flow-mediated diameter increase in the SCF group was significantly smaller than that in the NCF group (3.48 +/- 0.10% compared with 9.11 +/- 0.10%, P < 0.001). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and people with NCF (16.8 +/- 1.1% compared with 171 +/- 1.1%, P = 0.87). Simple regression analysis showed that mean CTFC (CTFCm) was strongly and inversely related to the percentage of FMD (r = -0.29, P < 0.01) in all participants. When the patients with SCIF were excluded, CTFC, was still inversely related to the percentage of FMD (r = -0.36, P < 0.05). CTFC, was also inversely related to NTG-induced dilatation in the 57 participants (r = -0.23, P < 0.05). Multiple regression analysis showed that CTFC, was inversely related to the percentage of FMD only (r = -0.37, P < 0.05). Conclusions These findings suggest that endothelial function is impaired in people with SCF and that CTFC correlates well with endothelial dysfunction.