Some features of slow-flow coronary syndrome in patients with long-term inflammation

Introduction. The pathogenesis of slow flow coronary syndrome and its reversibility are not fully understood, which makes it difficult to treat these patients. Recently, there has been increasing evidence that inflammation plays a significant role in the development of these syndromes. The aim of this study was to investigate the functional or fixed nature of slow coronary blood flow and the potential reversibility of these changes in a chronic inflammation model. Material and methods. The study included 19 patients with pulmonary tuberculosis who had signs of slowdown in coronary blood flow according to coronary angiography. A modified TIMI scale was used to assess the rate of movement of the radiocontrast agent. To assess the reversibility and possible functional nature of the changes, all angiographic studies were performed before and after intracoronary administration of 100 μg of nitroglycerin. The effects of antituberculosis chemotherapy and surgical treatment were evaluated. Conclusions. The syndrome of slow coronary flow in patients with long-term chronic inflammation is not functional in most cases, but rather fixed. Conservative or surgical treatment aimed at eliminating the source of the inflammatory response is not accompanied by normalization of coronary flow.