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Published in: BMC Cardiovascular Disorders 1/2018

Open Access 01-12-2018 | Research article

Correlation of increased corrected TIMI frame counts and the topographical extent of isolated coronary artery ectasia

Authors: Wei Wu, Shuyang Zhang, Yuchao Guo, Ruifeng Liu, Zhujun Shen, Xueqing Zhu, Zhenyu Liu

Published in: BMC Cardiovascular Disorders | Issue 1/2018

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Abstract

Background

The precise relationship between increased thrombolysis in myocardial infarction (TIMI) frame counts and the topographical extent of isolated coronary artery ectasia (CAE) has not been fully explained. New parameters of linear dimension (LD) and the estimated ectatic area (EEA) together with the diameter and ectasia ratio may be associated with the corrected TIMI frame count (CTFC) in isolated CAE patients.

Methods

The topographical parameters of ectatic coronary arteries and/or segments of 77 isolated CAE patients were consecutively studied. The CTFC for each coronary artery was determined by angiographic frame count.

Results

Right coronary artery (RCA) was the most frequently affected. The RCA and left circumflex (LCX) had significantly longer LD (p < 0.001 for both), and greater EEA (p < 0.001 for both) than those of left anterior descending artery (LAD). Similarly, the RCA and LCX have higher CTFCs (p = 0.001 and p = 0.008, respectively) than LAD. All topographic parameters and CTFCs were positively correlated with Markis classification. Linear regression analyses revealed that CTFCs were strongly correlated with diameter, LD, ectasia ratio and EEA, while EEA was the best predictor for the CTFC. Among multiple linear and nonlinear regression models, the cubic model between the CTFC and EEA exhibits the best Goodness-of-Fit.

Conclusion

The severity of the topographical extent of CAE was significantly correlated with increased CTFCs. Both the linear dimension and ectatic diameter (combined as EEA) were important for evaluating decreased coronary flow in isolated CAE patients.
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Literature
1.
go back to reference Swayes PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, Mudd JG, Gosselin AJ. Aneurysmal coronary artery disease. Circulation. 1983;67(1):134–8.CrossRef Swayes PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, Mudd JG, Gosselin AJ. Aneurysmal coronary artery disease. Circulation. 1983;67(1):134–8.CrossRef
2.
go back to reference Demopoulos VP, Olympios CD, Fakiolas CN, Pissimissis EG, Economides NM, Adamopoulou E, Foussas SG, Cokkinos DV. The nature history of aneurysmal coronary artery disease. Heart. 1997;78(2):136–41.CrossRefPubMedPubMedCentral Demopoulos VP, Olympios CD, Fakiolas CN, Pissimissis EG, Economides NM, Adamopoulou E, Foussas SG, Cokkinos DV. The nature history of aneurysmal coronary artery disease. Heart. 1997;78(2):136–41.CrossRefPubMedPubMedCentral
3.
go back to reference Papadakis MC, Manginas A, Cotileas P, Demopoulos V, Voudris V, Pavlides G, Foussas SG, Cokkinos DV. Documentation of slow coronary flow by the TIMI frame count in patients with coronary ectasia. Am J Cardiol. 2001;88(9):1030–2.CrossRefPubMed Papadakis MC, Manginas A, Cotileas P, Demopoulos V, Voudris V, Pavlides G, Foussas SG, Cokkinos DV. Documentation of slow coronary flow by the TIMI frame count in patients with coronary ectasia. Am J Cardiol. 2001;88(9):1030–2.CrossRefPubMed
4.
go back to reference Mavrogeni S, Manginas A, Papadakis E, Douskou M, Cokkinos D, Katsiva V, Foussas S, Voudris V, Giakoumelos A, Seimenis I, et al. Coronary flow evaluation by TIMI frame count and magnetic resonance flow velocity in patients with coronary artery ectasia. J Cardiovasc Magn Reson. 2005;7(3):545–50.CrossRefPubMed Mavrogeni S, Manginas A, Papadakis E, Douskou M, Cokkinos D, Katsiva V, Foussas S, Voudris V, Giakoumelos A, Seimenis I, et al. Coronary flow evaluation by TIMI frame count and magnetic resonance flow velocity in patients with coronary artery ectasia. J Cardiovasc Magn Reson. 2005;7(3):545–50.CrossRefPubMed
5.
go back to reference Sayin T, Doven O, Berkalp B, Akyürek O, Güleç S, Oral D. Excercise-induced myocardial ischemia in patients with coronary artery ectasia without obstructive coronary artery disease. Int J Cardiol. 2001;78(2):143–9.CrossRefPubMed Sayin T, Doven O, Berkalp B, Akyürek O, Güleç S, Oral D. Excercise-induced myocardial ischemia in patients with coronary artery ectasia without obstructive coronary artery disease. Int J Cardiol. 2001;78(2):143–9.CrossRefPubMed
6.
go back to reference Brunetti ND, Salvemini G, Cuculo A, Ruggiero A, De Gennaro L, Gaglione A, Di Biase M. Coronary artery ectasia is related to coronary slow flow and inflammatory activation. Atherosclerosis. 2014;233(2):636–40.CrossRefPubMed Brunetti ND, Salvemini G, Cuculo A, Ruggiero A, De Gennaro L, Gaglione A, Di Biase M. Coronary artery ectasia is related to coronary slow flow and inflammatory activation. Atherosclerosis. 2014;233(2):636–40.CrossRefPubMed
7.
go back to reference Akyurek O, Berkalp B, Sayin T, Kumbasar D, Kervancioglu C, Oral D. Altered coronary flow properties in diffuse coronary artery ectasia. Am Heart J. 2003;145(1):66–72.CrossRefPubMed Akyurek O, Berkalp B, Sayin T, Kumbasar D, Kervancioglu C, Oral D. Altered coronary flow properties in diffuse coronary artery ectasia. Am Heart J. 2003;145(1):66–72.CrossRefPubMed
8.
go back to reference Kosar F, Acikgoz N, Sahin I, Topal E, Aksoy Y, Cehreli S. Effect of ectasia size or the ectasia ratio on the thrombosis in myocardial infarction frame count in patients with isolated coronary artery ectasia. Heart Vessel. 2005;20(5):199–202.CrossRef Kosar F, Acikgoz N, Sahin I, Topal E, Aksoy Y, Cehreli S. Effect of ectasia size or the ectasia ratio on the thrombosis in myocardial infarction frame count in patients with isolated coronary artery ectasia. Heart Vessel. 2005;20(5):199–202.CrossRef
9.
go back to reference Kosar F, Acikgoz N, Sahin I, Topal E, Gunen H, Ermis N, Cehreli S. Effects of co-existence of coronary stenosis and the extent of coronary ectasia on the TIMI frame count in patients with coronary artery ectasia. Int Heart J. 2005;46(2):211–8.CrossRefPubMed Kosar F, Acikgoz N, Sahin I, Topal E, Gunen H, Ermis N, Cehreli S. Effects of co-existence of coronary stenosis and the extent of coronary ectasia on the TIMI frame count in patients with coronary artery ectasia. Int Heart J. 2005;46(2):211–8.CrossRefPubMed
10.
go back to reference Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, McCabe CH, Raymond L, Fortin T, Poole WK, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996;93(5):879–88.CrossRefPubMed Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, McCabe CH, Raymond L, Fortin T, Poole WK, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996;93(5):879–88.CrossRefPubMed
11.
go back to reference Dodge JT Jr, Brown BG, Bolson EL, Dodge HT. Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation. 1992;86(1):232–46.CrossRefPubMed Dodge JT Jr, Brown BG, Bolson EL, Dodge HT. Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation. 1992;86(1):232–46.CrossRefPubMed
12.
go back to reference Dhawan J, Bray CL. Are Asian coronary arteries smaller than Caucasian? A study on angiographic coronary artery size estimation during life. Int J Cardiol. 1995;49(3):267–9.CrossRefPubMed Dhawan J, Bray CL. Are Asian coronary arteries smaller than Caucasian? A study on angiographic coronary artery size estimation during life. Int J Cardiol. 1995;49(3):267–9.CrossRefPubMed
13.
go back to reference Markis JE, Joffe CD, Cohn PF, Feen DJ, Hermann MV, Gorlin R. Clinical significance of coronary arterial ectasia. Am J Cardiol. 1976;37(2):217–22.CrossRefPubMed Markis JE, Joffe CD, Cohn PF, Feen DJ, Hermann MV, Gorlin R. Clinical significance of coronary arterial ectasia. Am J Cardiol. 1976;37(2):217–22.CrossRefPubMed
14.
go back to reference Quinn GP, Keough MJ. Experimental design and data analysis for biologists: Cambridge: Cambridge University Press; 2002. p. 112–52. Quinn GP, Keough MJ. Experimental design and data analysis for biologists: Cambridge: Cambridge University Press; 2002. p. 112–52.
15.
go back to reference Senen K, Yetkin E, Turhan H, Atak R, Sivri N, Battaloglu B, Tandogan I, Ileri M, Kosar F, Ozdemir R, et al. Increased thrombolysis in myocardial infarction frame counts in patients with isolated coronary artery ectasia. Heart Vessel. 2004;19(1):23–6.CrossRef Senen K, Yetkin E, Turhan H, Atak R, Sivri N, Battaloglu B, Tandogan I, Ileri M, Kosar F, Ozdemir R, et al. Increased thrombolysis in myocardial infarction frame counts in patients with isolated coronary artery ectasia. Heart Vessel. 2004;19(1):23–6.CrossRef
16.
go back to reference Zografos TA, Korovesis S, Giazitzoglou E, Kokladi M, Venetsanakos I, Paxinos G, Fragakis N, Katritsis DG. Clinical and angiographic characteristics of patients with coronary artery ectasia. Int J Cardiol. 2013;167(4):1536–41.CrossRefPubMed Zografos TA, Korovesis S, Giazitzoglou E, Kokladi M, Venetsanakos I, Paxinos G, Fragakis N, Katritsis DG. Clinical and angiographic characteristics of patients with coronary artery ectasia. Int J Cardiol. 2013;167(4):1536–41.CrossRefPubMed
17.
go back to reference Gulec S, Atmaca Y, Kilickap M, Akyürek O, Aras O, Oral D. Angiographic assessment of myocardial perfusion in patients with isolated coronary artery ectasia. Am J Cardiol. 2003;91(8):996–9.CrossRefPubMed Gulec S, Atmaca Y, Kilickap M, Akyürek O, Aras O, Oral D. Angiographic assessment of myocardial perfusion in patients with isolated coronary artery ectasia. Am J Cardiol. 2003;91(8):996–9.CrossRefPubMed
18.
go back to reference Krüger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronaropathy”). J Am Coll Cardiol. 1999;34(5):1461–70.CrossRefPubMed Krüger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronaropathy”). J Am Coll Cardiol. 1999;34(5):1461–70.CrossRefPubMed
19.
go back to reference Kim W, Jeong MH, Ahn YK, Cho JG, Park JC, Kang JC. The changes of fractional flow reserve after intracoronary nitrate and Nicorandil injection in coronary artery ectasia. Int J Cardiol. 2006;113(2):250–1.CrossRefPubMed Kim W, Jeong MH, Ahn YK, Cho JG, Park JC, Kang JC. The changes of fractional flow reserve after intracoronary nitrate and Nicorandil injection in coronary artery ectasia. Int J Cardiol. 2006;113(2):250–1.CrossRefPubMed
20.
go back to reference Ari H, Ari S, Erdogan E, Tiryakioğlu O, Huysal K, Koca V, Bozat T. The effects of endothelial dysfunction and inflammation on slow coronary flow. Turk Kardiyol Dern Ars. 2010;38(5):327–33.PubMed Ari H, Ari S, Erdogan E, Tiryakioğlu O, Huysal K, Koca V, Bozat T. The effects of endothelial dysfunction and inflammation on slow coronary flow. Turk Kardiyol Dern Ars. 2010;38(5):327–33.PubMed
21.
go back to reference Cicek Y, Durakoglugil ME, Erdogan T, Yilmaz A, Uydu HA, Saglam H, Cetin M, Satiroglu O, Bostan M, Canga A, et al. Increased plasminogen activator inhibitor-1 levels in patients with isolated coronary artery ectasia. J Thromb Thrombolysis. 2012;33(1):120–3.CrossRefPubMed Cicek Y, Durakoglugil ME, Erdogan T, Yilmaz A, Uydu HA, Saglam H, Cetin M, Satiroglu O, Bostan M, Canga A, et al. Increased plasminogen activator inhibitor-1 levels in patients with isolated coronary artery ectasia. J Thromb Thrombolysis. 2012;33(1):120–3.CrossRefPubMed
22.
go back to reference Yasar AS, Erbay AR, Ayaz S, Turhan H, Metin F, Ilkay E, Sabah I. Increased platelet activity in patients with isolated coronary artery ectasia. Coron Artery Dis. 2007;18(6):451–4.CrossRefPubMed Yasar AS, Erbay AR, Ayaz S, Turhan H, Metin F, Ilkay E, Sabah I. Increased platelet activity in patients with isolated coronary artery ectasia. Coron Artery Dis. 2007;18(6):451–4.CrossRefPubMed
23.
go back to reference Wu W, Liu R, Chen L, Chen H, Zhang S. Disequilibrium of blood coagulation and fibrinolytic system in patients with coronary artery ectasia. Medicine (Baltimore). 2016;95(8):e2779.CrossRef Wu W, Liu R, Chen L, Chen H, Zhang S. Disequilibrium of blood coagulation and fibrinolytic system in patients with coronary artery ectasia. Medicine (Baltimore). 2016;95(8):e2779.CrossRef
24.
go back to reference Balta S, Demirkol S, Celik T, Kucuk U, Unlu M, Arslan Z, Balta I, Iyisoy A, Kocak N, Haqmal H, et al. Association between coronary artery ectasia and neutrophil-lymphocyte ratio. Angiology. 2013;64(8):627–32.CrossRefPubMed Balta S, Demirkol S, Celik T, Kucuk U, Unlu M, Arslan Z, Balta I, Iyisoy A, Kocak N, Haqmal H, et al. Association between coronary artery ectasia and neutrophil-lymphocyte ratio. Angiology. 2013;64(8):627–32.CrossRefPubMed
25.
go back to reference Ayhan SS, Ozturk S, Erdem A, Ozlü MF, Ozyaşar M, Erdem K, Yazıcı M. Relation of neutrophil/lymphocyte ratio with the presence and severity of coronary artery ectasia. Turk Kardiyol Dern Ars. 2013;41(3):185–90.CrossRefPubMed Ayhan SS, Ozturk S, Erdem A, Ozlü MF, Ozyaşar M, Erdem K, Yazıcı M. Relation of neutrophil/lymphocyte ratio with the presence and severity of coronary artery ectasia. Turk Kardiyol Dern Ars. 2013;41(3):185–90.CrossRefPubMed
26.
go back to reference Liu R, Chen L, Wu W, Chen H, Zhang S. Neutrophil serine proteases and their endogenous inhibitors in coronary artery ectasia patients. Anatol J Cardiol. 2016;16(1):23–8.PubMed Liu R, Chen L, Wu W, Chen H, Zhang S. Neutrophil serine proteases and their endogenous inhibitors in coronary artery ectasia patients. Anatol J Cardiol. 2016;16(1):23–8.PubMed
27.
go back to reference Liu R, Chen L, Wu W, Chen H, Zhang S. Extracellular matrix turnover in coronary artery ectasia patients. Heart Vessel. 2016;31(3):351–9.CrossRef Liu R, Chen L, Wu W, Chen H, Zhang S. Extracellular matrix turnover in coronary artery ectasia patients. Heart Vessel. 2016;31(3):351–9.CrossRef
28.
go back to reference Antonopoulos AS, Siasos G, Oikonomou E, Mourouzis K, Mavroudeas SE, Papageorgiou N, Papaioannou S, Tsiamis E, Toutouzas K, Tousoulis D. Characterization of vascular phenotype in patients with coronary artery ectasia: the role of endothelial dysfunction. Int J Cardiol. 2016;215:138–9.CrossRefPubMed Antonopoulos AS, Siasos G, Oikonomou E, Mourouzis K, Mavroudeas SE, Papageorgiou N, Papaioannou S, Tsiamis E, Toutouzas K, Tousoulis D. Characterization of vascular phenotype in patients with coronary artery ectasia: the role of endothelial dysfunction. Int J Cardiol. 2016;215:138–9.CrossRefPubMed
29.
go back to reference Koc F, Kalay N, Ardic I, Ozbek K, Celik A, Ceyhan K, Kadi H, Karayakali M, Sahin S, Altunkas F, et al. Antioxidant status and levels of antioxidant vitamins in coronary artery ectasia. Coron Artery Dis. 2011;22(5):306–10.CrossRefPubMed Koc F, Kalay N, Ardic I, Ozbek K, Celik A, Ceyhan K, Kadi H, Karayakali M, Sahin S, Altunkas F, et al. Antioxidant status and levels of antioxidant vitamins in coronary artery ectasia. Coron Artery Dis. 2011;22(5):306–10.CrossRefPubMed
Metadata
Title
Correlation of increased corrected TIMI frame counts and the topographical extent of isolated coronary artery ectasia
Authors
Wei Wu
Shuyang Zhang
Yuchao Guo
Ruifeng Liu
Zhujun Shen
Xueqing Zhu
Zhenyu Liu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2018
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-018-0833-1

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