Correlation between endothelial dysfunction in normal coronary patients with slow flow and aortic ectasia: the first report.

BACKGROUND Slow coronary flow (SCF) is slow dye progression in the coronary arteries during selective angiography, but there is no such study about greater visceral vessels. Studies have suggested that flow-mediated dilation (FMD) is impaired in SCF. Endothelial function can be assessed by FMD in the brachial artery as ischemia-induced vasodilation. Since inflammation is an underlying pathology in the inflammation of visceral vessels and probably SCF, we studied the correlation of aortic ectasia and SCF by means of FMD. METHODS Patients with normal coronary arteries and SCF formed the case group, and patients with normal coronary arteries and normal coronary flow formed the control group. We measured the diameter of the patients' brachial artery at rest, after inflation of a sphygmomanometer on the forearm [endothelial-dependent vasodilation (EDV)], and after use of sublingual nitrate (endothelial-independent vasodilation) by sonography. We also measured the diameter of the aorta using sonography before administration of sublingual nitrate. Endothelial dysfunction was defined as EDV significantly less than standard EDV. RESULTS There were insignificant differences between age, gender, and frequency of cardiac risk factors within the case and control groups, but diabetes mellitus was significantly different between the two groups. The diameter of the aorta was insignificantly different between the case and control groups. The response of the brachial artery to the cuff test and sublingual nitrate were insignificantly different between the case and control groups. Endothelial dysfunction based on cuff test and sublingual nitrate administration was significantly more common in men than women, as the p values for cuff and sublingual nitrate were 0.033 and 0.051, respectively. CONCLUSIONS It seems that there is no correlation between SCFP and aortic ectasia.