Background Coronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echoca...Background Coronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography (TTDE) in the diagnosis and monitoring of coronary slow flow in left anterior descending (LAD) coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities (DPV) and diastolic mean velocities (DMV) were calculated.Results Sixty of 65 (92.3%) subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group ((0.228±0.029) m/s vs. (0.302±0.065) m/s, P=0.000; (0.176±0.028) m/s vs. (0.226±0.052) m/s, P=0.000,respectively). There was a high inverse correlation between CTFC and coronary DPV and DMV (r=-0.727, P=0.000;r=-0.671, P=0.000, respectively). Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) was less than one half for coronary DPV (AUC=0.104) and DMV (AUC=0.204), respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.展开更多
Coronary artery anomalies (CAAs) are present at birth, but are usually asymptomatic and are found during coronary angiography or multi-slice computed tomography (MSCT) examinations. Their prevalence is less than 1...Coronary artery anomalies (CAAs) are present at birth, but are usually asymptomatic and are found during coronary angiography or multi-slice computed tomography (MSCT) examinations. Their prevalence is less than 1.3% based published series.1'2 The most common coronary anomaly is separate origin of the left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX) from the left sinus of the Valsalva. The second most common anomaly is the origin of the LCX artery from the right coronary artery (RCA) or right sinus of the Valsalva. We present two cases of coronary artery anomalies: one is the left main coronary artery (LMCA) arising from the proximal RCA, the other is the LAD originating from the proximal RCA.展开更多
目的研究ST段抬高型心肌梗塞患者血小板淋巴细胞比率(platelet to lymphocyte ratio, PLR)与左冠状动脉前降支病变位置的关系。方法纳入2014年9月-2016年8月在本院就诊的57例急性前壁心肌梗塞患者,根据冠脉造影检查结果将患者分为前降...目的研究ST段抬高型心肌梗塞患者血小板淋巴细胞比率(platelet to lymphocyte ratio, PLR)与左冠状动脉前降支病变位置的关系。方法纳入2014年9月-2016年8月在本院就诊的57例急性前壁心肌梗塞患者,根据冠脉造影检查结果将患者分为前降支近段狭窄组(近段组)和前降支中段狭窄组(中段组),统计分析PLR与其他计量资料之间的关系。结果近段组患者PLR值显著高于中段组患者(P=0.009),左室射血分数显著低于中段组患者(P<0.01)。PLR与心肌损伤标志物CK-MB和cTnI呈正相关(r值分别为0.314、0.287,P<0.05),与左室射血分数呈负相关(r=-0.269,P=0.036)。结论 PLR值可用于预测急性前壁心肌梗塞患者左冠状动脉前降支狭窄的位置,PLR值大预示心肌梗塞患者左冠状动脉前降支近段狭窄。展开更多
基金This study was supported by grants from National Natural Science Foundation of China (No. 81070166) and Scientific Research Common Program of Beijing Municipal Commission of Education (No. KM201010025020).Acknowledgement: We are grateful to all staff members of the Department of Cardiology and Catheterization Laboratory, Beijing Anzhen Hospital, Capital Medical University.
文摘Background Coronary slow flow phenomenon (CSFP) is an important, angiographic clinical entity but is lacking non-invasive detecting techniques. This study aimed to elucidate the value of transthoracic Doppler echocardiography (TTDE) in the diagnosis and monitoring of coronary slow flow in left anterior descending (LAD) coronary artery.Methods We consecutively enrolled 27 patients with CSFP in LAD detected by coronary arteriography from August 2009 to April 2010. Thirty-eight patients with angiographically normal coronary flow served as control. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) was used to document coronary flow velocities. All subjects underwent TTDE within 24 hours after coronary angiography. LAD flow was detected and the coronary diastolic peak velocities (DPV) and diastolic mean velocities (DMV) were calculated.Results Sixty of 65 (92.3%) subjects successfully underwent TTDE. Baseline clinical characteristics were similar between the two groups. Coronary DPV and DMV of LAD were significantly lower in the CSFP group than in the control group ((0.228±0.029) m/s vs. (0.302±0.065) m/s, P=0.000; (0.176±0.028) m/s vs. (0.226±0.052) m/s, P=0.000,respectively). There was a high inverse correlation between CTFC and coronary DPV and DMV (r=-0.727, P=0.000;r=-0.671, P=0.000, respectively). Receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) was less than one half for coronary DPV (AUC=0.104) and DMV (AUC=0.204), respectively.Conclusions In patients with CSFP, there is a high inverse correlation between CTFC and coronary diastolic flow velocities in the LAD coronary artery, as measured by TTDE. The value of TTDE in the monitoring and evaluation of coronary flow in patients with CSFP deserves further investigation.
文摘Coronary artery anomalies (CAAs) are present at birth, but are usually asymptomatic and are found during coronary angiography or multi-slice computed tomography (MSCT) examinations. Their prevalence is less than 1.3% based published series.1'2 The most common coronary anomaly is separate origin of the left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX) from the left sinus of the Valsalva. The second most common anomaly is the origin of the LCX artery from the right coronary artery (RCA) or right sinus of the Valsalva. We present two cases of coronary artery anomalies: one is the left main coronary artery (LMCA) arising from the proximal RCA, the other is the LAD originating from the proximal RCA.