Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2016
Student: MUSTAFA CANDEMİR
Supervisor: NURİ BÜLENT BOYACI
Abstract:Purpose: Pathophysiology and prognosis are not clearly determined in patients with coronary slow flow. These patients have different clinical presentations that vary from asymptomatic patients up to sudden cardiac death. In this study, we aimed to evaluate late gadolinium enhancement in cardiac magnetic resonance imaging relationship with myocardial fibrosis and the relationship between the presence of myocardial fibrosis and NT-proBNP levels in patients with slow flow in the left anterior descending coronary artery. Methods: This study is a prospective cohort study. A total of 31 patients were enrolled within an the age range of 31-75, who underwent coronary angiography because of chest pain, Sixteen patients were included in the study group and 15 patients in the control group. The study group patients have normal epicardial coronary arteries at angiography but slow flow in the left anterior descending artery. The control group patients also have normal epicardial coronary arteries at angiography but a normal TIMI flow. TIMI frame count method was used for diagnosis of coronary slow flow. In both groups, the patients are examined by cardiac magnetic resonance imaging (CMR) with a special protocol. In addition, plasma NT-proBNP levels are measured. Results: A total of 31 patients were included in this study (27 males and 4 female, mean age 50,3±10,7 years). The rate of positive results on CMR was significantly higher in patients with slow coronary flow (p=0,018). Varying amount of myocardial scar tissue was detected in 4 patients at left ventricular apeks and in 2 patients at anterolateral region. There was no difference in the level of NT-proBNP in patients with slow coronary flow. The significance of CMR findings was not related to demographic features and TIMI flow in patients with slow flow. In addition, the NT-proBNP levels was higher in patients with slow coronary flow, who had scarring in CMR (p=0,022). Conclusion: In the presnt study, with late gadolinium enhancement CMR, we showed that ischemic myocardial scarring may exist in patients with slow coronary flow. These results indicate that slow flow phenomenon may not be an innocent phenomenon.