Decreased coronary blood flow velocity in patients with aortic insufficiency but normal coronary arteries: the use of TIMI frame count in aortic insufficiency cases.

Patients with aortic insufficiency (AI) may suffer from anginapector is in the absence of obstructive coronaryartery disease. In this study, we aimed to investigate coronary blood flow using the thrombolysis in myocardialinfarction (TIMI) frame count (TFC) method in patients with AI and normal coronaryarteries. The study included 64 patients (Group 1; meanage 62.4 ± 13.2 years) with moderate to severe AI who had under gonecoronaryangio graphy that resulted in angiographically normal coronaries, and 42 patients with a typical chest pain and angiographically normal coronaryarteriogram (Group 2; meanage 58.8 ± 9.8 years). All patients under went coronaryangiography either to exclude coronaryartery disease or to evaluate their coronaryanatomy before aorticvalve replacement. TFC was calculated and compared for each artery, including the left anterior descending (LAD), circumflex (LCX), and right coronaryartery (RCA) in both groups. The base line characteristics of the study groups were similar. In both groups, TIMI-3 flow was present in eachartery at the time of arteriography, and the coronaryarteries were entirely normal. LCx and RCA frame counts and corrected LAD frame counts were significantly higher in Group 1 than in Group 2 (26.4 ± 2.1 vs. 24.3 ± 3.6, P < 0.05; 22.1 ± 2.3 vs. 20.5 ± 2.9, P < 0.05; and 22.5 ± 1.8 vs. 20.5 ± 2.4, P < 0.05, respectively). The TFC method may be used as a marker forcoronary flowvelocity in patients with aortic insuffiency and angiographically normal coronaryarteries toestimate decreased coronary blood flowve locity.