| Objective: To explore the value of platelet activation markers P-selectin(CD62P)and platelet membrane glycoprotein Ⅱb/Ⅲa fibrinogen receptor(PAC-1),as well as three-dimensional echocardiography(3DE)in the diagnosis and evaluation of coronary slow flow phenomenon(CSFP).Methods:93 patients were included in this study who underwent coronary angiography because of chest tightness and chest pain admitted to The Second Hospital of Dalian Medical University from February 2021 to August 2022.They were divided into NCSFP group(n=66)and CSFP group(n=27)according to the definition and diagnostic criteria of CSFP.Basic information were collected including age,gender,BMI,smoking,drinking,hypertension,diabetes.Biochemical data were collected including glucose(Glu),blood routine,liver function,renal function,blood lipids,flow cytometry results of platelet activation markers CD62 P and PAC-1.36 patients had underwent 3DE examination.Indicators measured by 3DE including left ventricular global longitudinal strain(LVGLS),left ventricular two-chamber longitudinal strain,left ventricular three-chamber longitudinal strain,left ventricular four-chamber longitudinal strain,early-diastolic left ventricular inflow velocity(E),ration of E and LVGLS(E/LVGLS).The correlation between platelet activation markers CD62 P,PAC-1 and CSFP was verified by univariate and multivariate logistic regression analysis.The correlation between longitudinal strain and E/LVGLS and CSFP is verified by single factor analysis.All the data analyses were carried out using R(http://www.r-project.org;version 3.4.3)and Empower Stats.The results were considered statistically significant with a P value < 0.05.Results:(1)Platelet activation markers expression of CD62 P and PAC-1 in the CSFP group were both higher than the NCSFP group.The optimal thresholds for CD62 P and PAC-1 in judging CSFP were determined by ROC curve.The optimal thresholds for CD62 P and PAC-1 were 30.9% and 8.5%,respectively.Logistic regression analysis found that the risk of developing CSFP in people with CD62 P ≥ 30.9% was 4.1times higher than people with CD62 P < 30.9%,and the risk of developing CSFP in people with PAC-1 ≥ 8.5% was 7.1 times higher than people with PAC-1 < 8.5%.(2)There were no significant differences in LVGLS,left ventricular two-chamber longitudinal strain,left ventricular three-chamber longitudinal strain,left ventricular four-chamber longitudinal strain,and E/LVGLS between CSFP group and NCSFP group.The optimal thresholds for above five metrics in judging CSFP were determined by ROC curve.The optimal thresholds for LVGLS,left ventricular two-chamber heart longitudinal strain,left ventricular three-chamber heart longitudinal strain,left ventricular four-chamber heart longitudinal strain,and E/LVGLS were 17.9%,18.45%,15.75%,19.45%,and 4.37,respectively.Univariate analysis after converting them into categorical variables showed that there were no significant differences in LVGLS,left ventricular two-chamber heart longitudinal strain,left ventricular three-chamber heart longitudinal strain,left ventricular four-chamber heart longitudinal strain,but the percentage of patients with E/LVGLS≥4.37 in the CSFP group was greater than that in the NCSFP group(58.8% vs 15.8%),and the difference was statistically significant.Conclusion:1.Platelet activation markers CD62 p and PAC-1 were correlated with the occurrence of CSFP,and the levels of CD62 P and PAC-1 in CSFP patients were higher.The risk of slow blood flow was significantly increased in people with CD62P≥30.9% and PAC-1≥8.5%.The increase in platelet activation may be involved in the occurrence of CSFP,which is expected to become an indicator for CSFP predicting.2.There was no difference in left ventricular systolic function measured by3 DE between CSFP patients and non-CSFP patients.E/LVGLS was associated with CSFP.The increase in E/LVGLS in CSFP patients suggested that CSFP patients may have early left ventricular diastolic dysfunction,and E/LVGLS may have potential value in predicting and evaluating CSFP. |
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