Study On The Relationship Between Serum Brain-derived Neurotrophic Factor And Coronary Slow Flow Phenomenon

Objective :As a biomarker,serum brain-derived neurotrophic factor(BDNF)has been considered to be closely related to coronary artery disease in recent years.However,its relationship with Coronary slow flow phenomenon(CSFP)remains unclear.Therefore,this study aims to explore the relationship between BDNF and CSFP in order to provide a theoretical basis for further understanding the mechanism of CSFP.Methods:This was a cross-sectional study.A total of 98 consecutive patients who underwent coronary angiography(CAG)in the Second Affiliated Hospital of Kunming Medical University from February 2022 to January 2023 were enrolled.Fifty-five patients diagnosed as CSFP according to TIMI frame count were selected as the study group,including 24 males and 31 females,with an average age of58.38±10.89 years.The CAG showed that 43 patients with Normal coronary flow(NCF)were selected as the control group,including 18 males and 25 females,with an average age of 60.49±10.96 years.The clinical data,blood biochemical test indicators,blood cell analysis,infection indicators,blood fibrinogen,myocardial injury markers,echocardiography and other related parameters and related medication of all subjects were collected.Serum BDNF levels were measured by enzyme-linked immunosorbent assay(ELISA).The clinical data and indicators of the two groups were compared and analyzed.Spearman’s correlation coefficient was used to test the correlation between the TFC of three coronary arteries,the mean TFC of three vessels and BDNF.Receiver operator characteristic curve(ROC)was drawn to determine the diagnostic value of BDNF in CSFP.Multivariate logistic regression analysis was used to determine the independent related factors of CSFP.Results:1.The NCF group compared with the CSFP group.In the NCF group,heart rate(77.00[70.00,84.00]vs65.00[61.00,68.00]),proportion of hypertension(28[65.1]vs22[40])and BDNF level(36.00 [28.31,P < 0.05)were significantly higher than those in the NCF group.45.60]vs27.72[22.64,34.7])and A peak([0.88±0.18]vs[0.80±0.18])in the CSFP group were higher than those in the CSFP group,and the difference was statistically significant(p<0.05).E/A ratio(0.76[0.67,0.97]vs0.85[0.75,1.20]),LAD corrected TFC(21.11[16.50,24.45]vs35.00[30.60,48.68]),LCX TFC(20.00[0.75,1.20])in the NCF group 18.00,24.00]vs36.00[30.00,44.00]),right coronary artery(RCA)TFC(20.00[16.00,23.75]vs34.00[26.00,42.00])and mean TFC(20.45[18.34,21.58]vs34.0)0[30.47,40.97])were significantly lower than those in the CSFP group(p<0.05).2.Spearman correlation analysis showed that serum BDNF was negatively correlated with left anterior descending artery(LAD)corrected TFC,left circumflex artery(LCX)TFC,and right coronary artery(RCA)TFC(LAD,r=-0.340,p =0.001;LCX,r=-0.270;p =0.008),(RAD,r=-0.266,p =0.001)and the average TIMI frame count of three vessels(r=-0.283,p =0.005)were also negatively correlated.3.Compared with CSFP group,the level of BDNF in normal coronary artery group was higher than that in two-vessel disease group(36.00 [28.71,44.78] vs28.03[21.66,30.55])and three-vessel disease group(36.00 [28.71,44.78] vs28.90[22.95,34.1]),and the difference between them was statistically significant.(p<0.05).4.The results of ROC curve analysis showed that the best cut-off value of BDNF for CSFP was 26.58ng/ml,and the Area under the curve(AUC)of BDNF was 72.2%(95%CI = 0.622-0.822,p< 0.0001),while the corresponding sensitivity and specificity were 90.7% and 45.5%,respectively.5 Multivariate binary Logistic regression analysis showed that heart rate(OR=0.851,95%CI:0.9= 791-0.961)and BDNF(OR=0.936,95%CI: 0.887-0.987)were independent influencing factors for CSFP.Conclusion(s):1.The serum BDNF level in CSFP group was lower than that in NCF group.After adjusting for potential confounding factors,serum BDNF was still an independent risk factor for CSFP.2.Serum BDNF was negatively correlated with the left anterior descending branch(LAD)corrected TFC,left cyclotron branch(LCX)TFC,right coronary artery(RCA)TFC and the average TFC frame number of the three vessels in all subjects.The TIMI frame count increased with decreasing serum BDNF concentration.3.The level of serum BDNF has a certain predictive value in the distinguishing patients with or without CSFP.Serum BDNF as a diagnostic indicator of CSFP has a high sensitivity,but low specificity.4.Heart rate,peak A and E/A ratio may also be related to the occurrence of CSFP.