Tohoku J. Exp. Med., 2011, 225(1)

Impaired Cerebral Circulation in Patients with Slow Coronary Flow

OSMAN KARAKAYA,¹ ABDULKADIR KOÇER,² ALI METIN ESEN,³ RAMAZAN KARGIN³ and IRFAN BARUTCU⁴

¹Bakirkoy Sadi Konuk Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
²Bezmialem University Faculty of Medicine, Department of Neurology, Istanbul, Turkey
³Kosuyolu Heart Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
⁴Avicenna Hospital, Department of Cardiology, Istanbul, Turkey

Slow coronary flow (SCF) is characterized by delayed opacification of coronary arteries during coronary angiography and is associated with myocardial perfusion abnormalities, ischemia or myocardial infarction. We hypothesized that SCF could be a part of systemic circulatory abnormalities. Therefore, the present study was conducted to investigate whether cerebral blood flow velocity is altered in patients with SCF. The study included 16 patients suffering from chest pain with angiographically proven SCF and 16 subjects suffering from atypical chest pain with angiographically normal coronary flow. All study subjects were selected among those who undergone routine cardiac catheterization. SCF was defined based on thrombolysis in myocardial infarction frame count that reflects coronary artery flow. Thrombolysis in myocardial infarction frame count was significantly higher in patients with SCF than those with normal coronary flow. The average peak systolic, end diastolic and mean flow velocities of the middle cerebral artery were measured and recorded in both groups by transcranial Doppler ultrasonography. Baseline demographic properties were similar in both groups. Echocardiographic parameters were also similar in patients with SCF and those with normal coronary flow. In contrast, both right and left middle cerebral artery peak systolic, end diastolic and mean flow velocities were significantly lower in patients with SCF than those with normal coronary flow. We conclude that cerebral blood flow velocity is significantly lower in patients with SCF. SCF phenomenon may reflect a part of impaired systemic circulation.

keywords —— cerebral blood flow; coronary angiography; slow coronary flow; thrombolysis in myocardial infarction frame count; transcranial Doppler

© 2011 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2011, 225, 13-16

Correspondence: Irfan Barutcu, M.D., Avicenna Hastanesi, Menderes Mah. Atisalani Cad. 19. sok. No: 2, Esenler, Istanbul, 34220 Turkey.

e-mail: irfanbarutcu@yahoo.com