Significance of coronary artery tone in patients with vasospastic angina

Department of Internal Medicine, Tottori University School of Medicine, Japan.

To investigate the relation between basal coronary artery diameter and development of coronary artery spasm, the diameters of the proximal, middle and distal segments of the three major coronary artery branches, together with that of the left main trunk, were measured on a control angiogram and after ergonovine and nitrate administration in 30 patients with vasospastic angina without significant organic stenosis, and in 35 patients without ischemic heart disease. The percent change in coronary diameter after ergonovine and nitrate administration compared with the control diameter was used as an index of coronary vasoreactivity. In patients with vasospastic angina, coronary artery responses to both ergonovine and nitrate were greater in the spastic segments than in the other segments (p less than 0.05), and those of the coronary arteries without spasm were greater than those of the coronary arteries in patients without ischemic heart disease (p less than 0.01). There were no significant differences between the coronary artery diameters in the two groups after nitrate administration, and the control diameters were less in patients with vasospastic angina than in patients without ischemic heart disease. These observations indicate that a coronary vasomotion disorder, which involves increased basal coronary artery tone and hypersensitivity to vasoconstrictive stimuli, not only at a localized segment but also in the entire coronary artery tree, is present in patients with vasospastic angina. Clinically, evaluation of basal coronary artery tone may be useful for predicting the occurrence and location of coronary artery spasm.

This article has been cited by other articles:

				S. Sueda, H. Kohno, H. Fukuda, N. Ochi, H. Kawada, Y. Hayashi, and T. Uraoka Frequency of Provoked Coronary Spasms in Patients Undergoing Coronary Arteriography Using a Spasm Provocation Test Via Intracoronary Administration of Ergonovine Angiology, July 1, 2004; 55(4): 403 - 411. [Abstract] [PDF]

				S. Sueda, H. Kohno, H. Fukuda, K. Watanabe, N. Ochi, H. Kawada, and T. Uraoka Limitations of Medical Therapy in Patients With Pure Coronary Spastic Angina Chest, February 1, 2003; 123(2): 380 - 386. [Abstract] [Full Text] [PDF]

				Y. Tanabe, E. Itoh, K. Suzuki, M. Ito, Y. Hosaka, I. Nakagawa, and M. Kumakura Limited role of coronary angioplasty and stentingin coronary spastic angina with organic stenosis J. Am. Coll. Cardiol., April 3, 2002; 39(7): 1120 - 1126. [Abstract] [Full Text] [PDF]

				K. Okumura, T. Osanai, T. Kosugi, H. Hanada, H. Ishizaka, T. Fukushi, T. Kamada, T. Miura, T. Hatayama, T. Nakano, et al. Enhanced phospholipase C activity in the cultured skin fibroblast obtained from patients with coronary spastic angina: possible role for enhanced vasoconstrictor response J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1847 - 1852. [Abstract] [Full Text] [PDF]

				Y. Miyao, K. Kugiyama, H. Kawano, T. Motoyama, H. Ogawa, M. Yoshimura, T. Sakamoto, and H. Yasue Diffuse intimal thickening of coronary arteries in patients with coronary spastic angina J. Am. Coll. Cardiol., August 1, 2000; 36(2): 432 - 437. [Abstract] [Full Text] [PDF]

				J. F. Beltrame, S. Sasayama, and A. Maseri Racial heterogeneity in coronary artery vasomotor reactivity: differences between Japanese and caucasian patients J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1442 - 1452. [Abstract] [Full Text] [PDF]

				K. Kugiyama, H. Yasue, K. Okumura, H. Ogawa, K. Fujimoto, K. Nakao, M. Yoshimura, T. Motoyama, Y. Inobe, and H. Kawano Nitric Oxide Activity Is Deficient in Spasm Arteries of Patients With Coronary Spastic Angina Circulation, August 1, 1996; 94(3): 266 - 272. [Abstract] [Full Text]

				T. Nakano, T. Osanai, H. Tomita, M. Sekimata, Y. Homma, and K. Okumura Enhanced Activity of Variant Phospholipase C-{delta}1 Protein (R257H) Detected in Patients With Coronary Artery Spasm Circulation, April 30, 2002; 105(17): 2024 - 2029. [Abstract] [Full Text] [PDF]