Kokyu to Junkan Volume 43, Issue 6 (June 1995)

Differences in Provoked Coronary Artery Spasm between Acetylcholine and Ergonovine Tests in Patients Who Underwent Both Provocation Tests Hiroshi Suzuki 1 , Youichi Takeyama 1 , Yuji Hamazaki 1 , Atsuo Namiki 1 , Hitoshi Matsubara 1 , Juichi Hiroshige 1 , Mikitaka Murakami 1 , Takashi Katagiri 1 1Third Department of Internal Medicine, Showa University School of Medicine Keyword: 冠攣縮 , アセチルコリン , エルゴノビン , coronary artery spasm , acetylcholine , ergonovine pp.583-587
Published Date 1995/6/15
DOI https://doi.org/10.11477/mf.1404901070
  • Abstract
  • Look Inside

To investigate differences in coronary arterial responses to spasm provoked by acetylcholine (ACh) and that provoked by ergonovine (Ergo) tests, we examined rates of provoked coronary artery spasm in patients who underwent both ACh and Ergo, and compared the positive sites of coronary artery spasm in patients showing positive in both tests. This study consisted of 246 consecutive patients who underwent both tests during cardiac catheterization. ACh, a maximum dose of 100 μEg was injected into the left coronary artery and 50 μEg was injected into the right coronary artery. Ergo, a maximum dose of 0.4mg was administered intravenously. Coronary artery spasm was defined as positive when it resulted in more than a 75% reduction in diameter of the arteries associated with concomitant chest pain and/or ischemic ST-segment changes on ECG. Coronary artery spasm was provoked in 42% by ACh compared with 20 % by Ergo (p<0.001) in patients who underwent both tests, and 16% (40cases) showed positive in both tests. In 40 cases showing positive in both tests, the site of provo-ked spasm was similar in 32.5% (13 cases) of the patients, partly similar in 27.5% (11 cases), and quite different in 40% (16 cases). The rate of spasm provo-ked by ACh was significantly higher than that provoked by Ergo. It is suggested that the mechanism by which coronary spasm is provoked might differ according to whether the agent is ACh on Ergo, because spasms were provoked at different sites in about 70 % of the patients examined by both tests. Therefore, both provocation tests would be necessary for a more precise and definite diagnosis of coronary artery spasm.

Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.


43巻6号 (1995年6月)
電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院