Arquivos brasileiros de cardiologia, vol.114, pp.540-551, 2020 (Journal Indexed in SCI Expanded)
Article / Article
Title of Journal :
Arquivos brasileiros de cardiologia
Background: Pathophysiology and prognosis are not clearly determined in patients with the coronary slow flow
phenomenon (CSFP). These patients present with various clinical conditions ranging from being asymptomatic to being
admitted with sudden cardiac death.
Objectives: We aimed at assessing the findings of late gadolinium enhancement (LGE) in cardiac magnetic resonance
imaging (CMR) as an indicator of myocardial fibrosis. We also aimed at determining the relationship between the
presence of myocardial fibrosis and NT-proBNP levels in patients with CSFP in the left anterior descending coronary
Methods: A total of 35 patients were enrolled within an age range of 31-75. The study patients (n=19) had normal
epicardial coronary arteries at angiography, but they presented with CSFP in the LAD. The control group patients (n=16)
had normal epicardial coronary arteries and TIMI scores at normal levels in angiography. In both groups, the patients
were examined with CMR for the presence of myocardial fibrosis. In addition, plasma NT-proBNP levels were measured.
A p-value < 0.05 was considered significant.
Results: The rate of myocardial fibrosis was significantly higher in CMR in the patients with CSFP (p=0.018). A variable
amount of myocardial scar tissue was detected at the left ventricular apex in 7 patients and at the inferior and inferolateral
regions in 3 patients. There was no difference in the level of NT-proBNP in patients with CSFP. However, the NT-proBNP
levels were higher in patients with CSFP, who had scar tissue in CMR (p=0.022).
Conclusions: In conclusion, LGE in CMR showed that ischemic myocardial scarring may exist in patients with CSFP.
These results indicate that CSFP may not always be innocent.