Assessment Of Myocardial Functions In Patients With Coronary Slow Flow And The Effects Of Nicorandil

Objective:To evaluate the left ventricular function and nitric oxide、 endothelin-1levelsin patients with left anterior descending coronary slow flow and the effects of Nicorandil.Methods:A total of56patients underwent coronary angiography for angina were enrolled. Of those36with left anterior descending coronary slow flow as CSF group,20patients with normal coronary angiography as control group.Left ventricular intemal dimensiondiastole(LVIDd),left ventricular internal dimension systole(LVIDs), left ventricular ejection fraction (LVEF),E peak,A peak and E/A ratio were assessed using routine heart Doppler ultrasonic.Longitudinal Strain(LS) of the six segments supplied only by left anterior descending artery regional were assessed using two dimensional speckle tracking imaging.Plasma nitric oxide、 endothelin-1levels were assessed in24hours ofcoronary angiography All quotas of the CSF group were assessed agin after treatment with Nicorandil5mg three times a day.Results:There was no significant difference in LVIDd, LVIDs and LVEF between the CSF group and the control group.Compared with the control group,the CSF group’s E peak、E/A ratio and Plasma nitric oxide decreased and A peak、ET-I increased. Ls in four of the six segments that single supplied by LAD decreased. Treatment with Nicorandil alleviate the angina of27patients of the CSF group in vary degrees and significantly increased E peak、E/A ratio and NO. The plasma level of ET-1decreased after the treaty of Nicorandil. Three of the four segments’ Ls has significant difference and one of the four Segments’Ls has no significant difference after treatment.Conclusion:The Routine heart Doppler ultrasonic suggests that left ventricular global diastolic function impaired and global systolic function not affected in patients with coronary slow flow.Two dimensional speckle tracking imaging suggest that regional systolic function has impaired in patients with coronary slow flow.The plasma Plasma nitric oxide decreased and endothelin-1level increased in coronary slow flow. Nicorandil maybe a effective drug for improve CSF patients’myocardial function、decreased ET-1、increased NO、and alleviate the angina symptom.