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Documentation of slow coronary flow by the TIMI frame count in patients with coronary ectasia

2001; Elsevier BV; Volume: 88; Issue: 9 Linguagem: Inglês

10.1016/s0002-9149(01)01984-1

1879-1913

Manolis Papadakis, Athanassios Manginas, Panayotis Cotileas, Vassilios Demopoulos, Vassilios V. Voudris, Gregory Pavlides, Stefanos Foussas, Dennis V. Cokkinos,

Acute Myocardial Infarction Research

Coronary artery ectasia (CAE) is characterized by segmental or diffuse dilation of the coronary arteries to >1.5 the diameter of the adjacent segments of the same artery or of different arteries; it has been found in about 5% of coronary arteriograms.1 It co-exists in about 80% of cases with obstructive coronary disease.1,2 CAE has been considered to be present with slow coronary flow; however, the only study in which coronary flow velocity was actually measured, even if indirectly, was published in 1978 when Swanton et al3 measured the coronary sinus flow in 2 patients with ectasia. In a recent study, Kruger et al4 found "stigmata" of impaired blood flow, such as "slow flow," "stasis," and "milking phenomenon" by subjective evaluation. In Kawasaki's syndrome, which presents with localized coronary aneurysms, Hamaoka and coworkers5 measured coronary flow velocity with the Flowire (Endosonics Corporation, California) and found coronary sinus flow to be significantly decreased inside the aneurysm but normal in the adjacent normal segments. In 1996, Gibson et al6 introduced the Thrombolysis In Myocardial Infarction (TIMI) frame count method for measuring coronary flow velocity from coronary arteriograms. This measurement has been significantly correlated with flow velocity measured with the Flowire by several investigators during baseline conditions or hyperemia.7,8 We applied this technique to measurement of the coronary flow velocity in patients with CAE, either coexisting with obstructive coronary artery disease or alone.