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Vasospastic heart failure: multiple spasm may cause transient heart failure?
Shozo Sueda1, Hiroaki Kohno, Akira Oshita
1Department of Cardiology, Saiseikai Saijo Hospital, Saijo, Japan. EZF03146@nifty.com
Journal of Cardiology
|December 1, 2009
Summary
Coronary artery spasm may cause transient heart failure in some patients with unknown causes. This study investigated the link between coronary spasm and heart failure, finding a correlation in a subset of patients.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- The relationship between heart failure and coronary artery spasm has not been previously reported.
- Investigating potential causes of heart failure is crucial for effective treatment.
Purpose of the Study:
- To explore the correlation between coronary artery spasm and heart failure.
- To identify coronary artery spasm as a potential cause of heart failure in specific patient populations.
Main Methods:
- Coronary arteriography and spasm provocation tests were conducted on 37 heart failure patients.
- Pharmacological spasm provocation tests were performed after controlling heart failure and discontinuing vasoactive drugs for 24 hours.
- Positive spasm was defined as a >90% reduction in coronary artery diameter.
Main Results:
- Coronary artery spasm was observed in 12 out of 37 patients (32%), with multiple spasms in 10 (83%) of those cases.
- Patients with positive coronary spasm showed significantly smaller left ventricular dimensions after one year of medical therapy compared to those without spasm.
- No significant differences in ejection fraction on admission were noted between the groups.
Conclusions:
- Coronary artery spasm, particularly multiple spasms, is implicated as a potential cause of transient heart failure.
- This finding may explain a subset of heart failure cases with unknown origins, especially in Japan.
- Further research is warranted to elucidate the mechanisms and prevalence.
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