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Zhu Q, Wang S, Huang X, Zhao C, Wang Y, Li X, Jia D, Ma C. Understanding the pathogenesis of coronary slow flow: Recent advances. Trends Cardiovasc Med 2024; 34:137-144. [PMID: 36516963 DOI: 10.1016/j.tcm.2022.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/24/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Coronary slow flow is taken to be indicative of delayed filling of terminal vessels of the coronary arteries in the absence of coronary stenosis, as detected using coronary angiography. Patients suffering from coronary slow flow typically experience recurrent chest pain, thereby markedly affecting their quality of life. The etiology and pathogenesis of coronary slow flow, which is gradually attracting clinical attention, have yet to be sufficiently established, although it is currently believed that they may be associated with endothelial dysfunction in the coronary arteries, inflammatory response, abnormalities in microvascular reserve function, subclinical atherosclerosis, blood cell and platelet abnormalities, and genetic factors. In this review, we provide a brief overview of recent progress in research on the pathogenesis of coronary slow flow with a view toward elucidating the possible underlying pathogenesis and identify targets and directions for the treatment of this condition.
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Affiliation(s)
- Qing Zhu
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Shitong Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Xin Huang
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Cuiting Zhao
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Yonghuai Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Xinxin Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Dalin Jia
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China.
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Martins CMDH, Monteiro Júnior JGDM, Torres DDOC, Sobral Filho DC, Morais MCS, Montarroyos UR, Silva IKD, Santos ACOD. Hematological Changes during Seven Days of Hospitalization in Patients with Acute Myocardial Infarction. Arq Bras Cardiol 2023; 120:e20230045. [PMID: 37937582 DOI: 10.36660/abc.20230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/16/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Acute myocardial infarction is a major cause of mortality worldwide, and atherosclerotic plaque formation is the main pathophysiological mechanism, which results in chronic inflammation that induces erythrocyte maturation and may cause an increase in the red cell distribution width (RDW) index. OBJECTIVE Evaluate the role of the anisocytosis index in patients with acute myocardial infarction in both types of infarctions as a predictor of severity. METHODS Patients were included in the study according to the inclusion/exclusion criteria, following the hospital routine based on their clinical and laboratory history. Statistical analyzes were performed according to each variable. All conclusions were drawn considering the significance level of 5%. RESULTS During the follow-up period, in the 349 patients analyzed, the mortality rate was associated with the variables RDW (CV) and RDW (SD), in those patients who died, an increase was noted, as demonstrated in the multivariate model, for the effects of an acute ST elevation myocardial infarction and the RDW, adjusted for confounding factors (p-value = 0.03 and 0.04). In contrast, the total number of erythrocytes (p-value = 0.00) and hemoglobin (p-value = 0.03) showed a decrease during severe patients' hospitalization. CONCLUSION The anisocytosis index was a predictive factor of mortality and can be used as an indicator of worse prognosis in patients with acute myocardial infarction.
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Affiliation(s)
| | - José Gildo de Moura Monteiro Júnior
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE - Brasil
- Faculdade de Ciências Médicas - Universidade de Pernambuco (FCM-UPPE), Recife, PE - Brasil
| | | | - Dario Celestino Sobral Filho
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE-UPE), Recife, PE - Brasil
- Faculdade de Ciências Médicas - Universidade de Pernambuco (FCM-UPPE), Recife, PE - Brasil
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Seyyed Mohammadzad MH, Khademvatani K, Gardeshkhah S, Sedokani A. Echocardiographic and laboratory findings in coronary slow flow phenomenon: cross-sectional study and review. BMC Cardiovasc Disord 2021; 21:230. [PMID: 33952204 PMCID: PMC8097949 DOI: 10.1186/s12872-021-02044-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 04/28/2021] [Indexed: 11/24/2022] Open
Abstract
Background Coronary sow-flow phenomenon (CSFP) is defined as slow passage of the contrast injected into the coronary arteries without distal obstruction of the vessel. Methods The present study was a cross-sectional, descriptive-analytical study performed at the Seyed-al-Shohada Heart Center during 2018–2019. The eligible patients based on the inclusion and exclusion criteria were divided into the study group showing the CSFP and the control group with normal epicardial coronary arteries. Results The study included 124 patients. 67.9% of the study group and 39.4% of the control group were male patients (p-value = 0.001), and the mean patient age was 52.18 ± 12.55 and 51.77 ± 10.36 years in the study and control groups, respectively (p-value = 0.18). The study group had a significantly higher BMI than the control group (p < 0.05) and also a higher prevalence of smoking and hypertension. The variables of ALC, Hct, Plt, MPV, RDW, Cr, triglyceride, TC, and LDL, were higher in the study group. Given the echocardiographic findings, the mean E wave was significantly lower in the study group, while the control group had a significantly higher GLS (p-value = 0.01). Also, left anterior descending artery was the most common artery involved with CSFP. Conclusion The CSFP was significantly more common in men, smokers, hypertensive patients, and patients with high BMI. Moreover, these patients had significantly higher platelet count, MPV, LDL, and FBS. Some other laboratory variables were also higher in these patients. Given the echocardiographic findings, mild diastolic dysfunction and low GLS were also observed in the study group.
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Affiliation(s)
- Mir Hosein Seyyed Mohammadzad
- Cardiology Department, Medical Faculty, Urmia University of Medical Sciences, 17 Shahrivar St., 571478334, Urmia, Iran
| | - Kamal Khademvatani
- Cardiology Department, Medical Faculty, Urmia University of Medical Sciences, 17 Shahrivar St., 571478334, Urmia, Iran
| | - Salar Gardeshkhah
- Cardiology Department, Medical Faculty, Urmia University of Medical Sciences, 17 Shahrivar St., 571478334, Urmia, Iran
| | - Amin Sedokani
- Cardiology Department, Medical Faculty, Urmia University of Medical Sciences, 17 Shahrivar St., 571478334, Urmia, Iran.
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Dai C, Chen Z, Qian J, Ge J. Red Cell Distribution Width as a Marker of Periprocedural Myocardial Infarction in Patients with Elective Percutaneous Coronary Intervention. J Cardiovasc Transl Res 2020; 14:449-456. [PMID: 33029742 DOI: 10.1007/s12265-020-10073-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Abstract
We aimed to investigate whether red cell distribution width (RDW) was associated with periprocedural myocardial infarction (PMI) in patients undergoing elective percutaneous coronary intervention (PCI). Among 1723 consecutive patients undergoing elective PCI, a total of 230 (13.3%) met the diagnostic criteria of PMI. The high RDW (≥ 12.6%) group tended to have PMI (15.4% vs. 11.2%, P = 0.010). RDW was an independent predictor of PMI whether as a categorical variable (adjusted odds ratio = 1.442, 95% confidence interval = 1.088 to 1.911, P = 0.011) or a continuous variable (adjusted odds ratio = 1.236, 95% confidence interval = 1.079 to 1.415, P = 0.002). High RDW was also significantly associated with increased risk of major adverse cardiovascular events (MACE) during follow-up. However, anemia was not independently associated with PMI or MACE in the current study. In conclusion, RDW showed strong and independent association with PMI in patients undergoing elective PCI.
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Affiliation(s)
- Chunfeng Dai
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Zhangwei Chen
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Juying Qian
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
| | - Junbo Ge
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
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An investigation of platelet parameters in smoking patients with coronary slow flow detected during coronary angiography. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.722658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhan XZ, Lin WD, Liu FZ, Xue YM, Liao HT, Li X, Fang XH, Deng H, Huang J, Li YQ, Hai JJ, Tse HF, Wu SL. Predictive value of red cell distribution width on left atrial thrombus or left atrial spontaneous echo contrast in patients with non-valvular atrial fibrillation. J Geriatr Cardiol 2018; 15:408-412. [PMID: 30108612 PMCID: PMC6087520 DOI: 10.11909/j.issn.1671-5411.2018.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 02/27/2018] [Accepted: 03/20/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the predictive value of red cell distribution width (RDW) on left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with non-valvular atrial fibrillation (AF). METHODS We reviewed 692 patients who were diagnosed as non-valvular AF and underwent transesophageal echocardiography (TEE) in Guangdong Cardiovascular Institute from April 2014 to December 2015. The baseline clinical characteristics, laboratory test of blood routine, electrocardiograph measurements were analyzed. RESULTS Eighty-four patients were examined with LAT/LASEC under TEE. The mean RDW level was significantly higher in LAT/LASEC patients compared with the non-LAT/LASEC patients (13.59% ± 1.07% vs. 14.34% ± 1.34%; P < 0.001). Receiver-operating characteristic curve analysis was performed and indicated the best RDW cut point was 13.16%. Furthermore, multivariate logistic regression analysis indicated that RDW level > 13.16% could be an independent risk factor for LAT/LASEC in patients with AF. CONCLUSION Elevated RDW level is associated with the presence of LAT/LASEC and could be with moderate predictive value for LAT/LASEC in patients with non-valvular AF.
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Affiliation(s)
- Xian-Zhang Zhan
- Department of Hematology, the First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei-Dong Lin
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Fang-Zhou Liu
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-Mei Xue
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hong-Tao Liao
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xin Li
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xian-Hong Fang
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jun Huang
- Department of Cardiology, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yang-Qiu Li
- Department of Hematology, the First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jo-Jo Hai
- Cardiology Division, Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Hung-Fat Tse
- Cardiology Division, Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China
- Division of Cardiology, Department of Medicine, the University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Shu-Lin Wu
- Department of Hematology, the First Affiliated Hospital, Jinan University, Guangzhou, China
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梁 琦, 雷 新, 李 红, 殷 艳, 任 洁, 范 力, 黄 欣, 袁 祖. [Regression analysis of red cell distribution width and mean platelet volume in patients with acute myocardial infarction]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1022-1027. [PMID: 28801280 PMCID: PMC6765727 DOI: 10.3969/j.issn.1673-4254.2017.08.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate clinical implications of changes in red cell distribution width (RDW) and mean platelet volume (MPV) in patients with acute myocardial infarction. METHODS A total of 127 patients (90 men and 37 women) were enrolled in this analysis, including 66 with acute myocardial infarction (AMI) and 61 with unstable angina (UA). The patients' baseline demographic and clinical data were compared between the two groups including age, hypertension, diabetes, smoking, BMI, blood biochemical profiles, cardiac functions and platelet and red blood cell parameters. The patients were further divided into subgroups according to the RDW 50% cumulative frequency, and the MPV, P-LCR, hsCRP, NT-proBNP, RBC, Dimer and MCV were compared. The correlations between platelet and erythrocyte test results were evaluated in both the AMI and UA patients. Regression analysis was performed to identify the factors affecting the RDW in the AMI group and a regression model was established. RESULTS The platelet and red blood cell test results, P-LCR, MPV, and RDW differed significantly between AMI and UA groups (P<0.01 or 0.05). Correlation analysis showed a significant positive correlation between RDW and MPV in AMI group (r=0.34, P<0.01). Between the subgroups with different RDW 50% cumulative frequencies, MPV, P-LCR, hsCRP, D-Dimer, and NT-proBNP all differed significantly (P<0.05 or 0.01). In AMI group, with RDW as the dependent variable, we established a multivariate regression model of RDW=0.19MPV+10.83. CONCLUSION RDW and MPV are closely correlated in patients with AMI. In multiple regression analysis, MPV can explain the changes in RDW in patients with AMI.
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Affiliation(s)
- 琦 梁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 新军 雷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 红兵 李
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 艳蓉 殷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 洁 任
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 力宏 范
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 欣 黄
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 祖贻 袁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
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Ghaffari S, Tajlil A, Aslanabadi N, Separham A, Sohrabi B, Saeidi G, Pourafkari L. Clinical and laboratory predictors of coronary slow flow in coronary angiography. Perfusion 2016; 32:13-19. [DOI: 10.1177/0267659116659918] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: The coronary slow-flow phenomenon (CSFP) is a multifactorial angiographic finding with no established pathogenesis. Objective: To investigate the role of clinical profile and laboratory findings in patients with CSFP. Methods: We prospectively recruited 69 patients with angiographically diagnosed CSFP and compared them with 88 patients with normal coronary flow. Demographic information, comorbidities and laboratory analysis, including complete blood count with differential, lipid profile and serum biochemical analysis, were documented and compared in univariate and multivariate analyses. Results: Patients with CSFP were more likely to be male and active smokers. Total cholesterol, triglyceride, hemoglobin and hematocrit, platelet count, mean platelet volume, platelet distribution width and red cell distribution width (RDW) were all higher in patients with CSFP. In multivariate regression analysis, including smoking, total cholesterol, hematocrit, fasting blood glucose and red cell distribution width, except fasting blood glucose, all variables were independently associated with CSFP. Receiver operating characteristic curve analysis revealed a cut-off point of 13.05% for RDW with a sensitivity of 74.6% and a specificity of 77.3% (p<0.001, AUC = 0.802) A cut-off value of 11.35% for PDW had a 89.9% sensitivity and 98.9% specificity for the prediction of CSFP (p<0.001, AUC = 0.970) Conclusion: The changes of circulating blood cell components in patients with CSFP may be indicative of underlying inflammation and endothelial dysfunction that should be investigated in experimental studies.
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Affiliation(s)
- Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Aslanabadi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Separham
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Sohrabi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Saeidi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology, University at Buffalo, Buffalo, NY, USA
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Altiparmak IH, Erkus ME, Kocarslan A, Sezen H, Gunebakmaz O, Sezen Y, Kaya Z, Yildiz A, Demirbag R. High aortic pulse-wave velocity may be responsible for elevated red blood cell distribution width in overweight and obese people: a community-based, cross-sectional study. Cardiovasc J Afr 2016; 27:246-251. [PMID: 26895298 PMCID: PMC5340901 DOI: 10.5830/cvja-2016-005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/19/2016] [Indexed: 11/29/2022] Open
Abstract
Background: Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (RDW) is associated with subclinical cardiac diseases. The aim of this study was to investigate the association between RDW and aortic stiffness in overweight or obese subjects. Methods: A total of 101 overweight or obese subjects without overt cardiovascular disorders, and 48 healthy controls were enrolled. RDW, aortic pulse-wave velocity (PWV) and augmentation index 75 (Aix75) were evaluated. The case subjects were divided into two sub-groups according to PWV values; ≥ 10 m/s in group I, and < 10 m/s in group II. Bivariate correlation and multiple regression analyses (stepwise) were performed. Results RDW and PWV were considerably increased in the case groups compared with the controls. RDW was significantly increased in group I compared with group II and the controls [median 12.0 m/s, interquartile range (IQR): 10.5–17.5; median 11.7 m/s, IQR: 10.2–14.2, and median 11.4 m/s, IQR: 9.6–15.5, p < 0.05, respectively]. Resting heart rate and age were higher in group I than group II (81 ± 11 vs 74 ± 12 beats/min and 41 ± 120 vs 36 ± 9 years, respectively, p < 0.05). Regression analyses revealed that while log-RDW, age and resting heart rate were independent predictors for aortic PWV, log-RDW was the most important predictor in the final model. Conclusions: RDW, resting heart rate and age independently predicted arterial stiffness, and RDW may be useful to provide an early recognition of subclinical atherosclerosis in overweight and obese individuals.
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Affiliation(s)
| | | | - Aydemir Kocarslan
- Department of Cardiovascular Surgery, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hatice Sezen
- Department of Clinical Biochemistry, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Ozgur Gunebakmaz
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Yusuf Sezen
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Zekeriya Kaya
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Ali Yildiz
- Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Recep Demirbag
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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Cetin MS, Ozcan Cetin EH, Canpolat U, Aydın S, Temizhan A, Topaloglu S, Aras D, Aydogdu S. An overlooked parameter in coronary slow flow phenomenon: whole blood viscosity. Biomark Med 2015; 9:1311-21. [PMID: 26612589 DOI: 10.2217/bmm.15.92] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: We aimed to assess the relationship between coronary slow flow phenomenon (CSFP) and whole blood viscosity (WBV). Materials & methods: Two hundred patients with CSFP and 200 subjects with normal coronary arteries as control group were enrolled. WBV was calculated from hematocrit and plasma protein concentration at low shear rate (LSR) (0.5 s-1) and high shear rate (HSR) (208 s-1) by a validated equation. Results: CSFP patients had significantly higher WBV for LSR and HSR. The mean corrected TIMI frame count was highest in the highest tertile group for both shear rates. Corrected TIMI frame count revealed a significant relationship with WBV for LSR (r = 0.562) and HSR (r = 0.611). At multivariate analysis, WBV at LSR and HSR were independent predictors of CSFP. Conclusion: WBV seemed to have a significant and an independent predictor of CSFP.
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Affiliation(s)
- Mehmet Serkan Cetin
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | | | - Ugur Canpolat
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Selahattin Aydın
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Temizhan
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Serkan Topaloglu
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Dursun Aras
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydogdu
- Turkey Yuksek Ihtisas Education & Research Hospital, Cardiology Clinic, Ankara, Turkey
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Abstract
OBJECTIVES There is accumulating evidence that inflammation plays a major role in the development of the slow coronary flow (SCF) phenomenon. YKL-40 has been suggested to be a potential biomarker of inflammation. In this study, we aimed to study YKL-40 as it relates to SCF. MATERIALS AND METHODS Patients who underwent coronary angiography before and had angiographically normal coronary arteries of varying coronary flow rates without any atherosclerotic lesion were enrolled in this study. Patients who had thrombolysis in myocardial infarction frame counts (TFC) above the normal cutoffs were considered to have SCF and those within normal limits were considered to have normal coronary flow (NCF). The YKL-40 levels and biochemical profiles of all patients were studied and analyzed. RESULTS There were 41 patients in the SCF group and 209 patients in the NCF group. Compared with the NCF patients, SCF patients had higher serum high-sensitivity C-reactive protein (hs-CRP) (P=0.0003) and YKL-40 (P=0.0007) levels. A positive correlation was detected between the YKL-40 levels and hs-CRP (r=0.7021, P<0.001), and the mean TFC (r=0.4038, P=0.0088) in SCF patients. CONCLUSION Our study showed that YKL-40 levels are higher and correlated positively with TFC and hs-CRP in SCF patients. This finding suggests that YKL-40 may be a useful marker and predictor for SCF.
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Altun I, Akin F, Kose N, Sahin C, Kirli I. Predictors of slow flow in angiographically normal coronary arteries. Int J Clin Exp Med 2015; 8:13762-13768. [PMID: 26550323 PMCID: PMC4613008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/28/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Slow coronary flow (SCF) is a well-known angiographic finding; however, the pathophysiology of SCF remains only partially understood. In this study, we have examined the risk factors of slow coronary flow. METHODS Seventy patients with angiographically proven SCF were studied along with 60 control participants. Patients were divided into 2 groups based on the angiographic findings as with or without SCF. In both groups, clinical information was collected and laboratory parameters were measured and compared. RESULTS Patients with SCF had higher serum uric acid, creatinine and hemoglobin levels. They also more commonly had a history of smoking. On the other hand, C-reactive protein and hematologic parameters such as mean platelet volume (MPV), red cell distribution width (RDW), and neutrophil to lymphocyte (N/L) ratio did not differ significantly between the two groups. In the logistic regression analysis, only uric acid (odds ratio [OR]=1.583, 95% confidence interval [CI]=1.011-2.349, P=0.034) was found as an independent correlate of SCF. CONCLUSIONS This study demonstrates that serum uric acid level is significantly correlated with SCF and may play a role in the development of the condition. These findings provide impetus for additional studies to confirm these results and treatment of SCF.
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Affiliation(s)
- Ibrahim Altun
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman UniversityMugla, Turkey
| | - Fatih Akin
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman UniversityMugla, Turkey
| | - Nuri Kose
- Department of Cardiology, Mugla Yucelen HospitalMuğla, Turkey
| | - Cem Sahin
- Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman UniversityMugla, Turkey
| | - Ismail Kirli
- Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman UniversityMugla, Turkey
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Gerede DM, Kaya CT, Vurgun VK, Acbuca A, Tak BT, Ongun A, Klckap M, Erol C. Red cell distribution width as a predictor of left atrial spontaneous echo contrast in echocardiography. Medicine (Baltimore) 2015; 94:e712. [PMID: 25860216 PMCID: PMC4554040 DOI: 10.1097/md.0000000000000712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Red cell distribution width (RDW) represents the heterogeneity of red blood cells (anisocytosis). Spontaneous echo contrast (SEC) is thought to be a manifestation of red cell aggregation and it has been linked to the development of thromboemboli. The aim of this study was to evaluate the association between RDW levels and the presence of left atrial SEC (LASEC). One-hundred and 72 patients who underwent transesophageal echocardiography for various indications were enrolled in the study. All patients were categorized into 2 groups according to the presence of LASEC and into 4 groups according to the severity of LASEC. The baseline clinical characteristics, echocardiographic measurements, and laboratory findings, including RDW, were compared between the groups. The RDW (%) level was higher in the LASEC group (14.95 ± 1.32) compared with the non-LASEC group (12.20 ± 1.45; P = 0.0001). When the relationship between RDW and SEC was evaluated according to the increasing grade of SEC, a significant positive correlation was found (r = 0.645, P < 0.0001). In the ROC analysis, an RDW level >13.8% had 70% sensitivity and 89.2% specificity in predicting LASEC (area under the curve = 0.834, P < 0.0001, 95% CI 0.656-0.773). In multivariate analysis, RDW levels >13.8% and the presence of atrial fibrillation were independently associated with LASEC (odds ratio [OR] 1.697; 95% confidence interval [CI] 1.198-2.085; P = 0.001 and OR 1.586; 95% CI 1.195-2.098; P = 0.003, respectively]. Elevated RDW value is associated with the presence and the severity of SEC. RDW may be a useful marker and independent predictor for the presence of SEC.
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Affiliation(s)
- Demet M Gerede
- From the Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
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14
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Shi GL, Cai XX, Su YM, Chen C, Deng XT, Pan HY, Fan MK, Zhu JH, Pan M. Interleukin-10 promotor -592A/C polymorphism is associated with slow coronary flow in Han Chinese. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:4091-4098. [PMID: 26097597 PMCID: PMC4466984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/20/2015] [Indexed: 06/04/2023]
Abstract
An accumulating body of evidence suggests that slow coronary flow (SCF) phenomenon seems to be an early-form of atherosclerosis and low-grade inflammation plays a major role in the atherosclerotic vascular processes. Interleukin (IL)-10 is a multifunctional cytokine involved in both innate and adaptive immune response. The aim of the present study is to investigate the association of IL-10 gene -592A/C polymorphism with SCF in Han Chinese. 250 patients who underwent coronary angiography and had angiographically normal coronary arteries of varying coronary flow rates without any atherosclerotic lesion were enrolled in this study. Patients who had thrombolysis in myocardial infarction frame counts (TFC) above the normal cutoffs were considered to have SCF and those within normal limits were considered to have normal coronary flow (NCF). The PCR-based restriction fragment length polymorphism (PCR-RFLP) technique was used to assess the genotypes frequencies. The distribution of the IL-10 -592A/C genotypes (AA, AC, and CC) was 46.34%, 41.46%, and 12.20% in the NCF group, and 66.51%, 28.71%, and 4.78% in SCF subjects, respectively (P = 0.0280). The frequency of the A allele in the SCF group was significantly higher than that in the NCF group (80.86% vs. 67.07%, P = 0.0054). Compared with the CC genotype, the AA genotype had increased risk of SCF in both unadjusted and adjusted analyses. In SCF patients, the average serum IL-10 levels in AA genotype were statistically lower than in AC + CC genotype (P = 0.0000). These findings suggest that IL-10 -592A/C polymorphism is associated with SCF and the A allele has increased risk for SCF in Han Chinese.
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Affiliation(s)
- Gui-Liang Shi
- Department of Cardiology, Xinghua People’s HospitalXinghua 225700, P. R. China
| | - Xing-Xing Cai
- Department of Cardiology, Affiliated Hospital of Nantong UniversityNantong 226001, P. R. China
| | - Ya-Min Su
- Department of Cardiology, Affiliated Hospital of Nantong UniversityNantong 226001, P. R. China
| | - Chu Chen
- Department of Cardiology, Affiliated Hospital of Nantong UniversityNantong 226001, P. R. China
| | - Xin-Tao Deng
- Department of Cardiology, Xinghua People’s HospitalXinghua 225700, P. R. China
| | - Hai-Yan Pan
- Department of Cardiology, Affiliated Hospital of Nantong UniversityNantong 226001, P. R. China
| | - Meng-Kan Fan
- Department of Cardiology, Xinghua People’s HospitalXinghua 225700, P. R. China
| | - Jian-Hua Zhu
- Department of Cardiology, Xinghua People’s HospitalXinghua 225700, P. R. China
| | - Min Pan
- Department of Cardiology, Xinghua People’s HospitalXinghua 225700, P. R. China
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15
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Assessment of risk factors and left ventricular function in patients with slow coronary flow. Heart Vessels 2014; 31:288-97. [DOI: 10.1007/s00380-014-0606-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 11/21/2014] [Indexed: 11/28/2022]
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16
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Li XL, Hong LF, Jia YJ, Nie SP, Guo YL, Xu RX, Zhu CG, Jiang LX, Li JJ. Significance of red cell distribution width measurement for the patients with isolated coronary artery ectasia. J Transl Med 2014; 12:62. [PMID: 24606910 PMCID: PMC3975450 DOI: 10.1186/1479-5876-12-62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/03/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Red cell distribution width (RDW) has been recognized as a novel marker for several cardiovascular diseases. The aim of this study was to evaluate the association between RDW levels and the presence of isolated coronary artery ectasia (CAE). METHODS We studied 414 subjects including 113 patients with isolated CAE (Group A), 144 patients with coronary artery disease (CAD, group B) and 157 angiographically normal controls (group C). Baseline clinical characteristics and laboratory findings including RDW were compared among three groups. RESULTS The levels of RDW were significantly higher in group A and B compared with that in group C (12.97 ± 1.4 and 12.88 ± 1.0 vs 12.34 ± 0.9, p = 0.020) while no difference was found between CAE and CAD (p = 0.17). Additionally, the levels of CRP were also higher in patients with CAE and CAD compared with normal controls (0.26 ± 0.14 mg/L, 0.31 ± 0.27 mg/L vs 0.20 ± 0.06 mg/L, p = 0.04). The multivariate analysis indicated that RDW and CRP were the independent variables most strongly associated with the presence of isolated CAE and CAD. There was a positive correlation between levels of RDW and CRP in patients with isolated CAE (γ=0.532, p = 0.001). CONCLUSIONS Our data suggested that RDW may be a useful marker and independent predictor for the presence of isolated CAE.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jian-Jun Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
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Luo SH, Li JJ. Authors' comments on: Higher red cell distribution width in patients with slow coronary flow. Clinics (Sao Paulo) 2013; 68:1289. [PMID: 24141847 PMCID: PMC3782735 DOI: 10.6061/clinics/2013(09)17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Song-Hui Luo
- State Key Laboratory of Cardiovascular Disease, Division of Cardiology, National Center for Cardiovascular Disease, CAMS and PUMC, Fu Wai Hospital, Beijing, China
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Balta S, Kucuk U, Arslan Z, Unlu M, Demirkol S, Celik T. Increased red cell distribution width in patients with slow coronary flow. Clinics (Sao Paulo) 2013; 68:1288. [PMID: 24141846 PMCID: PMC3782721 DOI: 10.6061/clinics/2013(09)16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Sevket Balta
- Department of Cardiology, Guilhane School of Medicine, Etlik-Ankara, Turkey
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