Understanding the pathogenesis of coronary slow flow: Recent advances

Trends Cardiovasc Med. 2024 Apr;34(3):137-144. doi: 10.1016/j.tcm.2022.12.001. Epub 2022 Dec 11.

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.

Keywords: Coronary slow flow; Endothelial dysfunction; Inflammatory responses; Microvascular reserve dysfunction; Pathogenesis.

Publication types

  • Review

MeSH terms

  • Chest Pain
  • Coronary Angiography / adverse effects
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / etiology
  • Coronary Artery Disease* / therapy
  • Coronary Circulation* / physiology
  • Coronary Vessels / diagnostic imaging
  • Humans
  • Quality of Life