Increased Thrombolysis in Myocardial Infarction Frame Counts in Patients with Chronic Aortic Regurgitation

Aim: The effects of chronic aortic regurgitation (AR) on coronary blood flow of systolic/diastolic phase and phase and coronary reserve have been shown. Whereas thrombolysis in myocardial infarction (TIMI) frame count, which incorporates coronary blood flow and a higher TIMI frame count (TFC) is reflect disordered resistance vessel function, has not yet been evaluated in chronic AR. Method: 33 patients with isolated chronic AR diagnosed by echocardiography and angiography, and 22 control groups with no coronary or valvular disease who underwent angiography for atypical chest pain were included in our study. Coronary blood flow was measured using TFC. Result: Coronary blood flow, echocardiographic and demographic parameters were compared between the two groups. The mean TFC is found to be higher in AR patients when compared to the control group. (left anterior descending coronary artery (LAD) TFC, 43±7.3 vs. 30±5.9 frames/s, p<0.001; Corrected LAD (cLAD) TFC, 25.0±4.3 vs. 17.6 ± 3.5 frames/s, p< 0.001; Left circumflex artery (LCx) TFC, 27.0±6.4 vs. 19.9±3.4 frames/s, p<0.001; and Right coronary artery (RCA) TFC, 25.8±5.5 vs. 19.9±4.7 frames/s, p<0.001; mean TFC, 26.3±5.4 vs.19.1±3.9 frames/s, p<0.001). Conclusion: This is the first study showing increase of TFC in chronic AR patients without CAD. It is thought to show impaired coronary blood flow, and may explain angina symptoms in chronic AR patients. At the same time, it could be used as a parameter showing severe AR.