著者

Seiji Hokimoto Koichi Kaikita Satoshi Yasuda Kenichi Tsujita Masaharu Ishihara Tetsuya Matoba Yasushi Matsuzawa Yoshiaki Mitsutake Yoshihide Mitani Toyoaki Murohara Takashi Noda Koichi Node Teruo Noguchi Hiroshi Suzuki Jun Takahashi Yasuhiko Tanabe Atsushi Tanaka Nobuhiro Tanaka Hiroki Teragawa Takanori Yasu Michihiro Yoshimura Yasuhide Asaumi Shigeo Godo Hiroki Ikenaga Takahiro Imanaka Kohei Ishibashi Masanobu Ishii Takayuki Ishihara Yunosuke Matsuura Hiroyuki Miura Yasuhiro Nakano Takayuki Ogawa Takashi Shiroto Hirofumi Soejima Ryu Takagi Akihito Tanaka Atsushi Tanaka Akira Taruya Etsuko Tsuda Kohei Wakabayashi Kensuke Yokoi Toru Minamino Yoshihisa Nakagawa Shozo Sueda Hiroaki Shimokawa Hisao Ogawa on behalf of the Japanese Circulation Society and Japanese Association of Cardiovascular Intervention and Therapeutics and Japanese College of Cardiology Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0779, (Released:2023-03-10)

被引用文献数

39

著者

Shozo Sueda Takaaki Ochi Kazuo Yano Kazuaki Mineoi Tadashi Kondou Naoto Ochi Yutaka Hayashi Hitoshi Kukita Shouzou Matsuda Hiroyuki Kawada Takashi Tsuruoka Tadao Uraoka

出版者

日本循環器学会

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.64, no.8, pp.559-565, 0001-01-01 (Released:2001-05-31)

参考文献数

30

被引用文献数

16 24

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The incidence of provoked coronary spasm with the standard single spasm provocation test has been relatively low in patients with rest angina. The present study examined the clinical usefulness of a newly designed spasm provocation test, an intracoronary injection of acetylcholine (ACh) following an ergonovine (ER) test, in patients with rest angina who demonstrated low disease activity and atypical chest pain. Triple sequential spasm provocation tests were performed in 24 patients with atypical chest pain who had no ischemia and in 40 patients with rest angina who had distinct ischemia. Initially, an ACh test (20-100μg) and then an ER test (40-64μg) were performed and then, if no spasm was provoked, an intracoronary injection of ACh was given after the ER test to evaluate coronary spasm. Coronary spasm was defined as total or subtotal occlusion. In the 24 patients with atypical chest pain, no spasm was provoked by intracoronary injection of either ACh or ER, but coronary spasms were induced in 2 patients using the new method, with the remaining 22 not experiencing spasm (specificity of new method, 92%). In the 40 patients with rest angina, intracoronary injection of ACh induced coronary spasm in 22 patients (group I) and 6 (group II) demonstrated spasm with intracoronary injection of ER. Coronary spasm was not induced by either the ACh test or the ER test in 12 patients (group III). The intracoronary administration of ACh after the ER test provoked spasm in 11 of 12 patients. Diffuse spasms were provoked in 10 of 11 patients. In patients with rest angina, the frequency of chest pain attacks in 1 month experienced by patients in group III (0.8±0.8) was significantly lower than that of patients in group I (7.0±5.3, p<0.01) or II (3.5±2.3, p<0.05). No serious or irreversible complications related to this new combined method were observed. In conclusion, this method was safe and reliable for the induction of coronary spasm in patients with rest angina who may have low disease activity.