PMID- 32267328 OWN - NLM STAT- MEDLINE DCOM- 20200909 LR - 20210114 IS - 1678-4170 (Electronic) IS - 0066-782X (Print) IS - 0066-782X (Linking) VI - 114 IP - 3 DP - 2020 Mar TI - Determination of Myocardial Scar Tissue in Coronary Slow Flow Phenomenon and The Relationship Between Amount of Scar Tissue and Nt-ProBNP. PG - 540-551 LID - S0066-782X2020000300540 [pii] LID - 10.36660/abc.2018149 [doi] AB - BACKGROUND: Pathophysiology and prognosis are not clearly determined in patients with the coronary slow flow phenomenon (CSFP). These patients present with various clinical conditions ranging from being asymptomatic to being admitted with sudden cardiac death. OBJECTIVES: We aimed at assessing the findings of late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (CMR) as an indicator of myocardial fibrosis. We also aimed at determining the relationship between the presence of myocardial fibrosis and NT-proBNP levels in patients with CSFP in the left anterior descending coronary artery (LAD). METHODS: A total of 35 patients were enrolled within an age range of 31-75. The study patients (n=19) had normal epicardial coronary arteries at angiography, but they presented with CSFP in the LAD. The control group patients (n=16) had normal epicardial coronary arteries and TIMI scores at normal levels in angiography. In both groups, the patients were examined with CMR for the presence of myocardial fibrosis. In addition, plasma NT-proBNP levels were measured. A p-value < 0.05 was considered significant. RESULTS: The rate of myocardial fibrosis was significantly higher in CMR in the patients with CSFP (p=0.018). A variable amount of myocardial scar tissue was detected at the left ventricular apex in 7 patients and at the inferior and inferolateral regions in 3 patients. There was no difference in the level of NT-proBNP in patients with CSFP. However, the NT-proBNP levels were higher in patients with CSFP, who had scar tissue in CMR (p=0.022). CONCLUSIONS: In conclusion, LGE in CMR showed that ischemic myocardial scarring may exist in patients with CSFP. These results indicate that CSFP may not always be innocent. (Arq Bras Cardiol. 2020; 114(3):540-551). FAU - Candemir, Mustafa AU - Candemir M AUID- ORCID: 0000-0002-3645-3912 AD - Yozgat City Hospital - Department of Cardiology , Yozgat - Turquia. AD - Gazi University - Faculty of Medicine - Department of Cardiology , Ankara - Turquia. FAU - Sahinarslan, Asife AU - Sahinarslan A AD - Gazi University - Faculty of Medicine - Department of Cardiology , Ankara - Turquia. FAU - Yazol, Merve AU - Yazol M AD - Sanliurfa Education and Research Hospital , Department of Radiology , Sanliurfa - Turquia. FAU - Oner, Yusuf Ali AU - Oner YA AD - Gazi University - Faculty of Medicine - Department of Radiology , Ankara - Turquia. FAU - Boyaci, Bulent AU - Boyaci B AD - Gazi University - Faculty of Medicine - Department of Cardiology , Ankara - Turquia. LA - eng LA - por PT - Journal Article PT - Research Support, Non-U.S. Gov't TT - Determinacao do Tecido Cicatricial do Miocardio no Fenomeno de Fluxo Coronario Lento e a Relacao entre a Quantidade de Tecido Cicatricial e o Nt-ProBNP. PL - Brazil TA - Arq Bras Cardiol JT - Arquivos brasileiros de cardiologia JID - 0421031 RN - 0 (Contrast Media) RN - 0 (Peptide Fragments) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) RN - AU0V1LM3JT (Gadolinium) SB - IM CIN - Arq Bras Cardiol. 2020 May-Jun;114(3):552-553. PMID: 32267329 MH - *Cicatrix MH - Contrast Media MH - Gadolinium MH - Humans MH - Natriuretic Peptide, Brain MH - *No-Reflow Phenomenon MH - Peptide Fragments PMC - PMC7792723 OAB - BACKGROUND: Pathophysiology and prognosis are not clearly determined in patients with the coronary slow flow phenomenon (CSFP). These patients present with various clinical conditions ranging from being asymptomatic to being admitted with sudden cardiac death. OBJECTIVES: We aimed at assessing the findings of late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (CMR) as an indicator of myocardial fibrosis. We also aimed at determining the relationship between the presence of myocardial fibrosis and NT-proBNP levels in patients with CSFP in the left anterior descending coronary artery (LAD). METHODS: A total of 35 patients were enrolled within an age range of 31-75. The study patients (n=19) had normal epicardial coronary arteries at angiography, but they presented with CSFP in the LAD. The control group patients (n=16) had normal epicardial coronary arteries and TIMI scores at normal levels in angiography. In both groups, the patients were examined with CMR for the presence of myocardial fibrosis. In addition, plasma NT-proBNP levels were measured. A p-value < 0.05 was considered significant. RESULTS: The rate of myocardial fibrosis was significantly higher in CMR in the patients with CSFP (p=0.018). A variable amount of myocardial scar tissue was detected at the left ventricular apex in 7 patients and at the inferior and inferolateral regions in 3 patients. There was no difference in the level of NT-proBNP in patients with CSFP. However, the NT-proBNP levels were higher in patients with CSFP, who had scar tissue in CMR (p=0.022). CONCLUSIONS: In conclusion, LGE in CMR showed that ischemic myocardial scarring may exist in patients with CSFP. These results indicate that CSFP may not always be innocent. (Arq Bras Cardiol. 2020; 114(3):540-551) OABL- eng COIS- Potencial Conflito de Interesses Declaro nao haver conflito de interesses pertinentes. EDAT- 2020/04/09 06:00 MHDA- 2020/09/10 06:00 PMCR- 2020/03/20 CRDT- 2020/04/09 06:00 PHST- 2019/08/15 00:00 [received] PHST- 2019/06/05 00:00 [accepted] PHST- 2020/04/09 06:00 [entrez] PHST- 2020/04/09 06:00 [pubmed] PHST- 2020/09/10 06:00 [medline] PHST- 2020/03/20 00:00 [pmc-release] AID - S0066-782X2020000300540 [pii] AID - abc.2018149 [pii] AID - 10.36660/abc.2018149 [doi] PST - ppublish SO - Arq Bras Cardiol. 2020 Mar;114(3):540-551. doi: 10.36660/abc.2018149.