Assessment of the relationship coronary slow flow and myocardial ischemia with timi frame count and myocardial perfusion scintigraphy

Purpose: It has been reported that coronary slow flow (CSF) is a type or an early stage of the diffuse atherosclerotic disease. Myocardial perfusion scintigraphy is a useful technique in the diagnosis and evaluation of the prognosis of the coronary artery disease. In the present study, we evaluated the relationship between CSF and myocardial defect and ischemia. Method: In our retrospective analysis, we compared the TIMI frame scores and myocardial defect and ischemia scores in patients with anginal complaints who had undergone myocardial perfusion scintigraphy and then coronary angiography. TIMI frame score was utilized to detect CSF. Quantitative perfusion SPECT (QPS) and quantitative gated SPECT (QGS) scoring systems were used to evaluate myocardial perfusion. Results: A total of 159 patients with normal coronary arteries were included in the study. Of these, 91 (58%) had CSF and 68 (42%) had normal coronary flow detected by angiography. Mean age of the patients was 56±12 years. Median Stres rTPD for Cx was 0,1 (0,0-1,3) in patients with CSF and was 0,0 (0,0-0,28) in those with normal flow (p=0,002). Median stress defect score was 1,0 (0,0-3,0) in patients with CSF and was 0,0 (0,0-2,0) those with normal flow (p= 0.031). Cx TIMI frame count was correlated positively with rTPD and stress perfusion defect score (r= 0,207; p= 0.009 and r= 0,159; p= 0.045). Neither ischemia score nor perfusion defects was correlated with slow flow in other myocardial regions. Conclusion: In patients with CSF, rTPD and stress perfusion defects for Cx territories were found to be higher when compared with patients with normal coronary flow. A weak correlation was observed between Cx TIMI frame count and rTPD and stress perfusion defect score. Key Words: coronary slow flow, TIMI frame count, myocardial perfusion scintigraphy.