For a long time the theories about the pathomechanism of atherosclerosis have emphasized the absolute role of inflammation. Later studies highlighting the importance of blood flow were published. Recently the interaction between these two atherosclerotic factors has been focused on in vitro and animal studies. In our study the general role of blood flow in the pathomechanism of ischemic heart disease was proven in humans (in vivo) as well. Inverse correlation was observed between coronary blood flow velocity and soluble intercellular adhesion molecule-1 production. The correlation is stronger with advanced disease severity, independently from traditional cardiovascular risk factors and levels of acute phase proteins. The role of blood flow focused our attention to a group of patients, in whom the coronary angiography evaluated no structural abnormalities despite proven myocardial ischaemia. Within this disease entity, known as coronary X-syndrome, a group of patients can be distinguished based on slower than TIMI III coronary blood flow. Beside general description of coronary X-syndrome, the second part of present review analyses the patient group with slower flow - known in the literature as "slow coronary flow phenomenon" -, which forms an independent subgroup based on its specific clinical, prognostic and biochemical features, suggesting a unique pathomechanism.
|Translated title of the contribution||Ischemic heart disease and coronary X-syndrome: The pathogenetic role of coronary blood flow|
|Number of pages||14|
|Publication status||Published - Dec 1 2006|
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