The effects of endothelial dysfunction and inflammation on slow coronary flow

arı, hasan; huysal, kağan; ERDOĞAN, Ercan; Bozat, Tahsin; KOCA, Vedat; Arı, Selma; TİRYAKİOĞLU, Osman

The effects of endothelial dysfunction and inflammation on slow coronary flow

Hasan ARI, (Sağlık Bakanlığı, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa, Türkiye)

Selma ARI, (Sağlık Bakanlığı, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa, Türkiye)

Ercan ERDOĞAN, (Sağlık Bakanlığı, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa, Türkiye)

Osman TİRYAKİOĞLU, (Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Bursa, Türkiye)

Kağan HUYSAL, (Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Biyokimya Kliniği, Bursa, Türkiye)

Vedat KOCA, (Sağlık Bakanlığı, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa, Türkiye)

Tahsin BOZAT (Sağlık Bakanlığı, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa, Türkiye)

Türk Kardiyoloji Derneği Arşivi

2 2

Yıl: 2010 Cilt: 38 Sayı: 5 Sayfa Aralığı: 327 - 333 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The effects of endothelial dysfunction and inflammation on slow coronary flow

Öz:

Amaç: Endotel disfonksiyonu ve enflamasyonun yavaş koroner akım (YKA) üzerine etkileri araştırıldı.Çalışma planı: Çalışmaya anjiyografide üç koroner arterinde de YKA dışında patoloji bulunmayan 26 hasta (grup 1, 13 kadın, 13 erkek; ort. yaş 58.8) ve koroner akımı normal olan 25 hasta (grup 2, 14 kadın, 11 erkek; ort. yaş 62.7) alındı. Koroner akım, sol ön inen (LAD), sirkumfleks (Cx) ve sağ koroner (RCA) arterler için TIMI (Thrombolysis In Myocardial Infarction) kare sayısı yöntemine göre hesaplandı. Endotel fonksiyonları, her iki grupta plazma asimetrik dimetilarginin (ADMA) düzeyleri, brakiyal arter endotel bağımlı akıma dayalı dilatasyon (FMD) ve nitrogliserin ile oluşturulan endotel bağımsız dilatasyon (NMD) ile değerlendirildi. Enflamasyonu değerlendirmek için yüksek duyarlıklı C-reaktif protein (hs-CRP) düzeyleri ölçüldü.Bulgular: Her koroner arter için TIMI kare sayısı grup 1’de grup 2’den anlamlı derecede yüksek bulundu (p<0.001). Grup 1’de ortalama FMD değeri anlamlı derecede düşük (%6.6±1.6 ve %11.2±1.6, p<0.001), ADMA düzeyi ise anlamlı derecede yüksek (0.8±0.2 µmol/l ve 0.5±0.1 µmol/l, p=0.002) bulunurken, NMD ve hs-CRP düzeyi açısından iki grup arasında anlamlı fark saptanmadı (p>0.05). Plazma ADMA düzeyi ile koroner TIMI kare sayıları arasında anlamlı pozitif ilişki (RCA: r=0.50, p=0.001; cLAD: r=0.46, p=0.004; Cx: r=0.32, p=0.04), FMD değerleri ile TIMI kare sayıları arasında anlamlı negatif ilişki saptandı (cLAD: r=-0.68, p=0.0003; Cx: r=-0.54, p=0.0004; RCA: r=-0.46, p=0.004); hs-CRP düzeyi ise TIMI kare sayıları ile anlamlı ilişki göstermedi. Çokdeğişkenli analizde, sadece ADMA (p=0.009) ve FMD (p=0.02) parametreleri YKA varlığını göstermede anlamlı bulundu.Sonuç: Bulgularımız, enflamasyondan ziyade, artmış ADMA düzeyleri ve bozulmuş FMD değerleri ile belirlenen endotel disfonksiyonunun YKA etyopatogenezinde rol oynadığını göstermektedir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Endotel disfonksiyonu ve enflamasyonun yavaş koroner akım üzerine etkisi

Öz:

Objectives: We evaluated the effects of endothelial dysfunction and inflammation on slow coronary flow (SCF).Study design: The study included 26 patients (group 1; 13 females, 13 males; mean age 58.8 years) who had normal coronary arteries but SCF in three coronary vessels and 25 subjects (group 2, 14 females, 11 males; mean age 62.7 years) with normal coronary arteries and normal flow. Coronary flow was quantified according to the TIMI (Thrombolysis In Myocardial Infarction) frame count method for the left anterior descending (LAD), circumflex (Cx), and right coronary (RCA) arteries. Endothelial function was assessed by plasma asymmetric dimethylarginine (ADMA) levels, brachial artery endothelium-dependent flow-mediated dilatation (FMD), and nitroglycerin-mediated dilatation (NMD). Inflammation was assessed by high-sensitivity C-reactive protein (hs-CRP) levels.Results: TIMI frame count was significantly higher in group 1 compared to group 2 for each artery (p<0.001). In group 1, the mean FMD was significantly lower (6.6±1.6% vs. 11.2±1.6%, p<0.001) and the mean ADMA level was significantly higher (0.8±0.2 µmol/l vs. 0.5±0.1 µmol/l, p=0.002), whereas NMD and hs-CRP levels did not differ significantly between the two groups (p>0.05). There was a significant correlation between plasma ADMA level and TIMI frame count (RCA: r=0.50, p=0.001; cLAD: r=0.46, p=0.004; Cx: r=0.32, p=0.04) and a significant negative correlation between FMD and TIMI frame count (cLAD: r=-0.68, p=0.0003; Cx: r=-0.54, p=0.0004; RCA: r=-0.46, p=0.004), but hs-CRP level was not correlated with TIMI frame count. In multivariate analysis, only ADMA (p=0.009) and FMD (p=0.02) were significant parameters to predict SCF.Conclusion: Our results suggest that endothelial dysfunction as determined by increased ADMA level and impaired FMD, rather than inflammation, plays a role in the etiopathogenesis of SCF.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	arı h, Arı S, ERDOĞAN E, TİRYAKİOĞLU O, huysal k, KOCA V, Bozat T (2010). The effects of endothelial dysfunction and inflammation on slow coronary flow. , 327 - 333.
Chicago	arı hasan,Arı Selma,ERDOĞAN Ercan,TİRYAKİOĞLU Osman,huysal kağan,KOCA Vedat,Bozat Tahsin The effects of endothelial dysfunction and inflammation on slow coronary flow. (2010): 327 - 333.
MLA	arı hasan,Arı Selma,ERDOĞAN Ercan,TİRYAKİOĞLU Osman,huysal kağan,KOCA Vedat,Bozat Tahsin The effects of endothelial dysfunction and inflammation on slow coronary flow. , 2010, ss.327 - 333.
AMA	arı h,Arı S,ERDOĞAN E,TİRYAKİOĞLU O,huysal k,KOCA V,Bozat T The effects of endothelial dysfunction and inflammation on slow coronary flow. . 2010; 327 - 333.
Vancouver	arı h,Arı S,ERDOĞAN E,TİRYAKİOĞLU O,huysal k,KOCA V,Bozat T The effects of endothelial dysfunction and inflammation on slow coronary flow. . 2010; 327 - 333.
IEEE	arı h,Arı S,ERDOĞAN E,TİRYAKİOĞLU O,huysal k,KOCA V,Bozat T "The effects of endothelial dysfunction and inflammation on slow coronary flow." , ss.327 - 333, 2010.
ISNAD	arı, hasan vd. "The effects of endothelial dysfunction and inflammation on slow coronary flow". (2010), 327-333.

APA	arı h, Arı S, ERDOĞAN E, TİRYAKİOĞLU O, huysal k, KOCA V, Bozat T (2010). The effects of endothelial dysfunction and inflammation on slow coronary flow. Türk Kardiyoloji Derneği Arşivi, 38(5), 327 - 333.
Chicago	arı hasan,Arı Selma,ERDOĞAN Ercan,TİRYAKİOĞLU Osman,huysal kağan,KOCA Vedat,Bozat Tahsin The effects of endothelial dysfunction and inflammation on slow coronary flow. Türk Kardiyoloji Derneği Arşivi 38, no.5 (2010): 327 - 333.
MLA	arı hasan,Arı Selma,ERDOĞAN Ercan,TİRYAKİOĞLU Osman,huysal kağan,KOCA Vedat,Bozat Tahsin The effects of endothelial dysfunction and inflammation on slow coronary flow. Türk Kardiyoloji Derneği Arşivi, vol.38, no.5, 2010, ss.327 - 333.
AMA	arı h,Arı S,ERDOĞAN E,TİRYAKİOĞLU O,huysal k,KOCA V,Bozat T The effects of endothelial dysfunction and inflammation on slow coronary flow. Türk Kardiyoloji Derneği Arşivi. 2010; 38(5): 327 - 333.
Vancouver	arı h,Arı S,ERDOĞAN E,TİRYAKİOĞLU O,huysal k,KOCA V,Bozat T The effects of endothelial dysfunction and inflammation on slow coronary flow. Türk Kardiyoloji Derneği Arşivi. 2010; 38(5): 327 - 333.
IEEE	arı h,Arı S,ERDOĞAN E,TİRYAKİOĞLU O,huysal k,KOCA V,Bozat T "The effects of endothelial dysfunction and inflammation on slow coronary flow." Türk Kardiyoloji Derneği Arşivi, 38, ss.327 - 333, 2010.
ISNAD	arı, hasan vd. "The effects of endothelial dysfunction and inflammation on slow coronary flow". Türk Kardiyoloji Derneği Arşivi 38/5 (2010), 327-333.