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Exercise-induced ischemia after successful percutaneous coronary intervention is related to distal coronary

Stefan H J Monnink1, René A Tio, Nic J G M Veeger

  • 1Thoraxcenter, Department of Cardiology, University Hospital Groningen, Groningen, The Netherlands. smonnink@hetnet.nl

Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
|August 22, 2003
PubMed

Insights

Late after coronary angioplasty, endothelial dysfunction contributes to myocardial ischemia. This study links exercise-induced ischemia to distal coronary endothelial dysfunction in patients post-percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Interventional Cardiology

Background:

  • Endothelial dysfunction can cause myocardial ischemia without significant coronary lesions.
  • Assessing the link between vasomotor function and inducible ischemia is crucial after coronary angioplasty.

Purpose of the Study:

  • To evaluate the correlation between endothelium-dependent vasomotor function and inducible ischemia.
  • To investigate endothelial function 6 months after successful single-vessel stenting.

Main Methods:

  • Coronary endothelial function assessed via acetylcholine infusion in 30 patients post-stenting.
  • Quantitative coronary angiography used to measure vessel diameter changes.
  • Maximal workload ergometric testing performed prior to endothelial function assessment.

Main Results:

  • Acetylcholine induced significant distal vasoconstriction in both stented and contralateral vessels.
  • Distal vasoconstriction was correlated and reversible with nitroglycerine.
  • Inducible ischemia predicted distal vasoconstriction in the stented vessel.

Conclusions:

  • Exercise-induced ischemia late after percutaneous coronary intervention is associated with distal coronary endothelial dysfunction.
  • Endothelial dysfunction plays a role in ischemia development even after successful stenting.
Abstract

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