Carotid artery blood velocity decreases in patients with coronary slow flow: A manifestation of systemic arteriosclerosis

Echocardiography. 2019 Dec;36(12):2234-2240. doi: 10.1111/echo.14540. Epub 2019 Nov 22.

Abstract

Objectives: Coronary slow flow phenomenon (CSFP) could be a manifestation of systemic arteriosclerosis, as coronary and carotid arteries have similar intimal thickening. However, as an initial cause of arteriosclerosis, hemodynamic changes in carotid arteries have rarely been studied.

Methods: Twenty patients with angiography-proven CSFP and 39 patients with normal coronary flow (NCF) were enrolled. TIMI frame counts (CTFC) were investigated. Carotid intima-media thickness (CIMT), peak systolic velocity (PSV), and end-diastolic velocity (EDV) were measured by ultrasonography, and shear rate (SR) and resistance index (RI) were calculated.

Results: The results showed that PSV, EDV, SR, and RI were significantly lower in patients with CSFP (p<0.01), but CIMT was significantly increased (P < 0.01). PSV, EDV, SR, and RI were negatively correlated with CTFC, while CIMT was positively correlated with CTFC. Logistic regression analysis revealed that PSV (OR = 0.95, P < 0.01) could be an independent protective factor against CSFP, but CIMT (OR = 1.10, P < 0.05) and male gender (OR = 9.89, P < 0.01) could be risk factors for CSFP.

Conclusions: The slow flow phenomenon was observed in both coronary and carotid arteries, which could be a characteristic manifestation of systemic arteriosclerosis in CSFP; the lower wall shear stress may be the underlying mechanism. Carotid ultrasound could be applied in the noninvasive diagnosis of CSFP in the future.

Keywords: carotid artery; coronary artery; hemodynamics; slow flow phenomenon.

MeSH terms

  • Arteriosclerosis / diagnosis
  • Arteriosclerosis / physiopathology*
  • Blood Flow Velocity / physiology*
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / physiopathology*
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / physiopathology*
  • Carotid Intima-Media Thickness*
  • Coronary Circulation / physiology*
  • Coronary Vessels / physiopathology*
  • Cross-Sectional Studies
  • Diastole
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Systole