Assessment of the Relationship of Slow Coronary Flow and Myocardial Ischemia by Using TIMI Frame Count and Intracoronary Ultrasound

Although the relationship between slow coronary flow (SCF) and coronary ischemia has been often emphasised, there is lack of knowledge on type and degree of this relation. The aim of this study is to evaluate the correlation of TIMI frame count and phasic coronary area change in existence of SCF and coronary ischemia; and in normal coronary pattern.
METHOD
After coronary angiography, left anterior descending coronary artery was assessed for TIMI frame rate by the number of cineframes; and systolodiastolic internal membrane areas (IMA) change at proximal segment by the in tracoronary ultrasound. Then, all the patients underwent myocardial scintigraphy. Group A; 19 (9 F, 10 M, mean age 55.5±12.1) who have SCF without ischemia on scintigraphy, Group B; 5 (2 F, 3 M, mean age 56.8± 12.3) who have SCF and ischemia on scintigraphy and Group C; 13 (5 F, 8 M, mean age 57. 1 ± 11 .4) who have no SCF and ischemia on scintigraphy were studied (All groups were similar for age and sex).
RESULTS
Group A and B were similar for sistolo-diastolic phasic IMA change ratios and TIMI frame counts (for both p>0.05). Systolo-diastolic IMA change ratio was lower in Group A than C (%5.1±4.4 and %13.7±6.0 respectively, p=0.00003) and TIMI frame count was higher in Group A than C (51.4±5. 1 and 31.8±4.2 frames respectively, p<0.0001).
CONCLUSION
Ischemia caused by SCF have not seem to have a direct relation with IMA phasic change ratio and TIMI frame count. But compared to normal coronary pattern, IMA phasic change was lower in the coronary pattern with SCF.