Abstract:
The Thrombolysis in myocardial infarction
(TIMI) frame count is a simple clinical tool for assessing
quantitative indexes of coronary blood flow. This measurement
has been significantly correlated with flow velocity
measured with a flow-wire by several investigators during
baseline conditions or hyperemia. In this study we aimed to
evaluate the coronary flow in patients with isolated coronary
artery ectasia by means of the TIMI frame count and
to compare the results with those of patients with angiographically
normal coronary arteries. The study population
consisted of 37 patients with coronary artery ectasia only in
the right coronary artery (RCA). The control group consisted
of 31 patients with angiographically proven normal
coronary arteries. Coronary artery ectasia was defined as
nonobstructive lesions of the coronary arteries with a luminal
dilatation 1.5-fold or more of the adjacent normal coronary
segments. The TIMI frame count was determined for
each major coronary artery in each patient according to the
methods first described by Gibson et al. The TIMI frame
count of RCA in the study group was significantly higher
than in that of the control group (51 17 vs 25 8, P
0.0001). The TIMI frame counts of the study group for the
left anterior descending and left circumflex coronary artery
were also significantly higher than those of the control
group (corrected TIMI frame count for LAD 42 11 vs
24 7, P 0.001; TIMI frame count for LCx 44 15 vs
25 9, P 0.001). In patients with coronary artery ectasia,
the TIMI frame count of the RCA was higher than that of
the left anterior descending and left circumflex coronary
artery (51 17 vs 42 11 and 44 15, respectively,
P 0.05). We have shown increased TIMI frame counts in
patients with isolated coronary artery ectasia and suggest
that the pathophysiological mechanism of coronary artery
ectasia is not a focal disease. TIMI frame counts can be
regarded as an index of the severity of impaired coronary
flow in patients with coronary artery ectasia.
