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Coronary slow flow phenomenon (coronary slow flow phenomenon, CSFP) to exclude coronary artery spasm, thrombosis, coronary artery, valvular heart disease, connective tissue disease and other factors affect coronary angiography found no coronary obvious lesions, but the phenomenon of coronary blood flow slowed. Although this phenomenon has already found, but so far the CSFP clinical manifestations, pathogenesis, and treatment is not very clear, related study also less. The two aspects of the subject from the endothelial function and myocardial microcirculation perfusion of CSFP study, preliminary exploration of the the CSFP pathological mechanism for clinical risk stratification, prognosis and prevention to help. The purpose of a relationship by measuring the CSFP plasma nitric oxide (NO), endothelin -1 (ET-1) and hydrogen sulfide (H2S) changes, explore endothelial function and CSFP. CSFP patients with myocardial blood flow by myocardial contrast echocardiography (MCE) quantitative assessment of perfusion of CSFP in patients with myocardial microcirculation. Method 1, selected 60 cases underwent coronary angiography (CAG) patients due to chest pain or discomfort and other symptoms of the same period, according to the results of coronary angiography, divided into CSFP group of 30 people and 30 people with normal blood flow (NCF). Application corrected TIMI frame count (CTFC) method to determine coronary blood flow velocity. 3, were measured in both groups plasma NO, ET-1, H2S content. 4, the two groups underwent myocardial contrast echocardiography (MCE) inspection, measuring and fitting image satisfaction segmental perfusion curve using quantitative analysis software to calculate the peak intensity (A), the slope of the curve (β) and regional myocardial perfusion amount ( A · β) to evaluate myocardial perfusion. Comparison of results between the two groups CTFC CSFP group coronary vascular mean the CTFC is greater than NCF group (40.67 ± 22.79 vs 24.78 ± 2.17, P lt; 0.0001); CSFP group left anterior descending artery (LAD), left circumflex artery (LCX), and average CFTC in the right coronary artery (RCA) were significantly larger than the the NCF group of (P lt; 0.0001). 2, between the two groups in plasma NO, H2S, and ET-1 compares the The CSFP plasma NO, H2S, levels significantly lower than the NCF group (35.21 ± 4.61 vs 57.97 ± 3.62 P lt; 0.0001, 38.7 ± 5.90 vs 64.24 ± 3.87 P lt; 0.0001), the CSFP plasma ET-1 levels significantly higher than the CSFP groups (P lt; 0.0001); CSFP group within a group, two groups, three groups of plasma NO and H2S levels NCF group were significantly lower compared to Plasma ET-1 level was significantly higher (61.25 ± 5.51 vs 35.98 ± 3.00, P lt; 0.0001); in CSFP groups, compared with a vascular group, two plasma NO, H2S levels were significantly decreased, ET-1 significantly higher (P lt; 0.0001); the 3 Pcs plasma NO, H2S level decreased more significantly, ET-1 was significantly higher (P lt; 0.0001) CSFP group within the LAD, LCX, RCA three subgroups plasma NO , ET-1, H2S content in comparison, the difference did not reach statistical significance (P gt; 0.05). 3, linear regression analysis showed that plasma NO of H2S level between CTFC and negative correlation (r = -0.68, P lt; 0.001; r = -0.75, P lt; 0.001), plasma ET-1 levels CTFC between the existence of a positive correlation (r = 0.71, P lt; 0.001). 4, between the two groups of myocardial perfusion indicators comparison shows CSFP patients of myocardial acoustic developing the curve peak intensity A below NCF group (4.57 ± 2.99 vs 7.75 ± 2.99, P lt; 0.05), myocardial blood flow velocity β significantly lower than NCF group (0.56 ± 0.27 vs 0.69 ± 0.39, P lt; 0.05), myocardial blood flow A · β below the NCF group (3.52 ± 1.46 vs 2.31 ± 1.03, P lt; 0.05) prompted CSFP patients with myocardial blood flow NCF group. The Conclusion 1 CSFP patients with endothelial function abnormalities lead to endogenous NO, H2S reduction and ET-1 abnormally elevated prompt endothelial function different CSFP occurred. 2, myocardial contrast echocardiography CSFP patients with myocardial perfusion below the the NCF group, further suggest the the CSFP presence of endothelial dysfunction associated with abnormal myocardial microcirculation.
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