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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
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Published on: August 18, 2016

Caucasian patients suffering from coronary vasospastic angina have an intact peripheral endothelium-dependent

Ali Yilmaz, Matthias Vöhringer, Anastasios Athanasiadis

    International Journal of Cardiology
    |June 20, 2008
    PubMed

    Insights

    Caucasian patients with vasospastic angina do not show decreased brachial artery flow-mediated dilation (FMD). This study found no link between coronary vasomotility and peripheral vasodilation in this group, suggesting racial differences in vasospastic angina.

    Area of Science:

    • Cardiology
    • Vascular Biology
    • Endothelial Function

    Background:

    • Vasospastic angina (coronary artery spasm) is a condition causing chest pain due to temporary narrowing of coronary arteries.
    • Previous research suggested impaired brachial artery flow-mediated dilation (FMD) in Japanese patients with vasospastic angina.
    • The pathophysiology of vasospastic angina may differ across racial groups.

    Purpose of the Study:

    • To investigate if Caucasian patients with vasospastic angina exhibit reduced brachial artery FMD.
    • To determine if serum factors associated with endothelial dysfunction are abnormal in these patients.
    • To explore potential racial differences in the mechanisms underlying vasospastic angina.

    Main Methods:

    • Prospective study comparing 33 Caucasian patients with coronary vasospastic angina to 19 controls with atypical chest pain.
    • Coronary vasospasm assessed via intracoronary acetylcholine (ACh) testing after ruling out coronary artery disease.
    • Brachial artery FMD measured using high-resolution ultrasound; endothelium-independent vasodilation assessed with nitroglycerin.

    Main Results:

    • No significant difference in brachial artery FMD between the coronary spasm group and the control group (7.05% vs. 7.12%, p=0.93).
    • No significant difference in response to nitroglycerin between the groups (21.88% vs. 21.48%, p=0.84).
    • Baseline brachial artery diameter was the only significant determinant of FMD (p<0.0001); no correlation found between coronary vasomotility and peripheral vasodilation.

    Conclusions:

    • Caucasian patients with vasospastic angina do not demonstrate impaired peripheral endothelial function (FMD).
    • Coronary vasomotility is not associated with peripheral endothelium-dependent or independent vasodilation in this population.
    • Findings suggest potential racial variations in the pathophysiology of vasospastic angina.

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