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Rho-kinase inhibition with intracoronary fasudil prevents myocardial ischemia in patients with coronary microvascular spasm

^* Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

View larger version (167K): [in a new window]   Figure 1 Representative coronary arteriograms and electrocardiographic (ECG) tracings (lead V4) of a patient from the fasudil group. (Top left) Baseline coronary arteriogram shows a normal left coronary artery. (Top right) Acetylcholine (ACh) induced angina and downsloping ST-segment depression, but no epicardial spasm. Lactate production was also noted. (Bottom left) The second ACh test after pretreatment with fasudil (F) did not provoke angina, ischemic ECG changes, epicardial spasm, or lactate production. (Bottom right) Normal coronary arteriograms after administration of isosorbide dinitrate.

View larger version (19K): [in a new window]   Figure 2 Bar graphs showing the incidence of angina and evidence of myocardial ischemia (ischemic electrocardiographic [ECG] changes, lactate production, or both) during the first (open bars) and second (solid bars) acetylcholine challenges. *p < 0.05, **p < 0.01, saline vs. fasudil (by the chi-squared test).