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Abnormal diffuse coronary vasomotion.

J M Lablanche1, R Deturck, J L Fourrier

  • 1Division of Cardiology, University of Lille, France.

European Heart Journal
|November 1, 1989
PubMed
Summary
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Assessing coronary vasomotor tone is challenging. A combined pharmacological test using ergometrine and isosorbide dinitrate effectively identifies diffuse abnormal coronary vasomotion (DAV) in patients with angina.

Area of Science:

  • Cardiology
  • Vascular Physiology

Background:

  • Assessing coronary vasomotor tone is difficult despite research on coronary artery spasm and vasoconstriction.
  • Conventional provocative tests may not detect all forms of abnormal coronary vasomotion.

Purpose of the Study:

  • To evaluate a combined pharmacological testing protocol for assessing coronary vasomotor tone.
  • To identify patients with diffuse abnormal coronary vasomotion (DAV) not detectable by standard tests.

Main Methods:

  • A combined intravenous injection protocol of ergometrine and isosorbide dinitrate was administered post-coronary arteriography.
  • Two indexes, total coronary vasomotion (TCV) and maximal total coronary vasomotion (max TCV), were defined and measured.

Main Results:

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  • Normal values for TCV and max TCV were established in 20 healthy subjects.
  • Out of 2758 patients, 40 with normal coronary arteries but DAV were identified.
  • Eleven patients with normal vasoconstriction/vasodilatation ranges were detected solely by the combined test.

Conclusions:

  • The combined ergometrine and isosorbide dinitrate test effectively identifies patients with DAV.
  • This method can detect abnormal coronary vasomotor tone missed by conventional tests, aiding in the diagnosis of angina.
  • Patients identified with DAV experienced angina at rest, with some showing electrocardiographic changes and prior myocardial infarction.