CORRELATION OF BASAL CORONARY-ARTERY TONE WITH CONSTRICTIVE RESPONSE TO ERGONOVINE IN PATIENTS WITH VARIANT ANGINA
CORRELATION OF BASAL CORONARY-ARTERY TONE WITH CONSTRICTIVE RESPONSE TO ERGONOVINE IN PATIENTS WITH VARIANT ANGINA
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DOI：
10.1016/0735-1097(93)90828-o
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发表时间：
1993-07-01
影响因子：
24
通讯作者：
TAKESHITA, A
中科院分区：
文献类型：
--
作者：
KUGA, T;EGASHIRA, K;TAKESHITA, A
目标.本研究旨在检测变异型心绞痛患者痉挛部位的基础冠状动脉张力是否升高，并确定基础动脉张力在预测冠状动脉痉挛激发中的意义。变异性心绞痛患者的基础冠状动脉张力是否升高，以前的数据一直存在争议。我们通过硝酸甘油诱导的20例变异型心绞痛患者和24例对照者的冠状动脉直径增加百分比来评估基础冠状动脉张力。我们还检测了冠状动脉基础张力和对麦角新碱的收缩反应之间的相关性。在变异型心绞痛患者中，痉挛是由较低剂量（1或5 μ g）麦角新碱引起的，痉挛部位的基础冠状动脉张力（分别为54 ± 15%或36 ± 16%）大于非痉挛部位（分别为40 ± 25%或25 ± 15%）（p < 0.05）。这些患者非痉挛部位的基础冠状动脉张力（p < 0.01）大于对照组（15 ± 6%）。在变异型心绞痛患者中，痉挛仅由较高剂量（15或50 μ g）的麦角新碱引起，痉挛和非痉挛部位的基础冠状动脉张力相当，与对照组无差异。冠状动脉基础张力升高（≥ 40%）预测痉挛激发的诊断敏感性和特异性分别为26%和98%。这些结果表明，升高的基础冠状动脉张力可能是有用的预测冠状动脉痉挛的激发，但正常水平的基础冠状动脉张力并不排除这种挑衅。
Objectives. This study was conducted to examine whether basal coronary artery tone is elevated at the spastic site in patients with variant angina and to determine the significance of basal artery tone in predicting provocation of coronary artery spasm.Background. Previous data have been conflicting on whether basal coronary artery tone is elevated in patients with variant angina.Methods. We assessed basal coronary artery tone by obtaining the percent increase in coronary artery diameter induced by nitroglycerin in 20 patients with variant angina and 24 control subjects. We also examined the correlation between basal coronary artery tone and the constrictive response to ergonovine.Results. In the patients with variant angina in whom spasm was provoked by the lower doses (1 or 5 mug) of ergonovine, basal coronary artery tone was greater (p < 0.05) at the spastic site (54 +/- 15% or 36 +/- 16%, respectively) than at the nonspastic site (40 +/- 25% or 25 +/- 15%, respectively). Basal coronary tone at the nonspastic site in these patients was greater (p < 0.01) than that in control subjects (15 +/- 6%). In the patients with variant angina in whom spasm was provoked only by the higher doses (15 or 50 mug) of ergonovine, basal coronary artery tone was comparable at the spastic and nonspastic sites and was not different from that in control subjects. The diagnostic sensitivity and specificity of elevated basal coronary artery tone (greater-than-or-equal-to 40%) in predicting provocation of spasm were 26% and 98%, respectively.Conclusions. These results indicate that elevated basal coronary artery tone may be useful in predicting provocation of coronary spasm, but the normal level of basal coronary artery tone does not exclude such provocation.