OBJECTIVES: The purpose of this study was to clarify clinical and angiographical characteristics of acetylcholine (ACh)-induced spasm in the right and left coronary artery. METHODS AND RESULTS: We performed 557 consecutive procedures of spasm provocation tests of ACh from January 1991 to December 2000 in patients without significant stenosis. ACh was injected in incremental doses of 20, 50 and 80 microg into the right coronary artery and in incremental doses of 20, 50 and 100 microg into the left coronary artery if spasm had not been provoked. Coronary spasm was defined as positive with more than 99% transient luminal narrowing. Proximal spasm was defined as that of segments 1, 2, 5, 6, 7 and 11 and distal spasm as that of segments 3, 4, 8, 9, 12, 13 and 14. Low-ACh-dose-induced spasms showed the clinical findings and angiographical characteristics of higher incidence of variant angina, proximal spasms, focal spasms, more ST elevation and ischemic heart disease. In contrast, angiographical characteristics of high-Ach-dose-induced spasms were distal spasms and diffuse spasms and there was less variant angina and less ST elevation. CONCLUSIONS: Lower ACh doses induced spasms more proximally and focally in the coronary artery, while higher doses of ACh provoked spasms more distally and diffusely.
OBJECTIVES: The purpose of this study was to clarify clinical and angiographical characteristics of acetylcholine (ACh)-induced spasm in the right and left coronary artery. METHODS AND RESULTS: We performed 557 consecutive procedures of spasm provocation tests of ACh from January 1991 to December 2000 in patients without significant stenosis. ACh was injected in incremental doses of 20, 50 and 80 microg into the right coronary artery and in incremental doses of 20, 50 and 100 microg into the left coronary artery if spasm had not been provoked. Coronary spasm was defined as positive with more than 99% transient luminal narrowing. Proximal spasm was defined as that of segments 1, 2, 5, 6, 7 and 11 and distal spasm as that of segments 3, 4, 8, 9, 12, 13 and 14. Low-ACh-dose-induced spasms showed the clinical findings and angiographical characteristics of higher incidence of variant angina, proximal spasms, focal spasms, more ST elevation and ischemic heart disease. In contrast, angiographical characteristics of high-Ach-dose-induced spasms were distal spasms and diffuse spasms and there was less variant angina and less ST elevation. CONCLUSIONS: Lower ACh doses induced spasms more proximally and focally in the coronary artery, while higher doses of ACh provoked spasms more distally and diffusely.
Authors: Peter Ong; Anastasios Athanasiadis; Andrea Perne; Heiko Mahrholdt; Tim Schäufele; Stephan Hill; Udo Sechtem Journal: Clin Res Cardiol Date: 2013-09-01 Impact factor: 5.460
Authors: Sung Il Im; Woong Gil Choi; Seung-Woon Rha; Byoung Geol Choi; Se Yeon Choi; Sun Won Kim; Jin Oh Na; Cheol Ung Choi; Hong Euy Lim; Jin Won Kim; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh Journal: Korean Circ J Date: 2013-07-31 Impact factor: 3.243
Authors: Thomas J Ford; Eric Yii; Novalia Sidik; Richard Good; Paul Rocchiccioli; Margaret McEntegart; Stuart Watkins; Hany Eteiba; Aadil Shaukat; Mitchell Lindsay; Keith Robertson; Stuart Hood; Ross McGeoch; Robert McDade; Peter McCartney; David Corcoran; Damien Collison; Christopher Rush; Bethany Stanley; Alex McConnachie; Naveed Sattar; Rhian M Touyz; Keith G Oldroyd; Colin Berry Journal: Circ Cardiovasc Interv Date: 2019-12-13 Impact factor: 6.546