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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Coronary stenosis vasomotion during dynamic exercise before and after PTCA
T M Suter1, O M Hess, A Bortone
1Department of Internal Medicine, Medical Policlinic, Cardiology, University Hospital, Zürich, Switzerland.
European Heart Journal
|December 1, 1989
Summary
Percutaneous transluminal coronary angioplasty (PTCA) reduces exercise-induced coronary vasoconstriction in patients with coronary artery disease. This improvement in coronary vasomotion after PTCA enhances blood flow and cardiac function.
Area of Science:
- Cardiology
- Vascular Physiology
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) significantly impacts coronary vasomotion.
- Percutaneous transluminal coronary angioplasty (PTCA) is a common intervention for CAD.
- The effect of PTCA on coronary vasomotion during exercise and pharmacologic stress is not fully understood.
Purpose of the Study:
- To evaluate coronary vasomotion in patients with CAD before and after successful PTCA.
- To assess changes in luminal area and vascular response to exercise and nitroglycerin.
Main Methods:
- Eight patients with CAD underwent evaluation before and after PTCA.
- Biplane quantitative coronary arteriography assessed luminal area of normal and stenotic arteries.
- Coronary vasomotion was tested at rest, during exercise, and after nitroglycerin administration.
Main Results:
- PTCA significantly reduced diameter stenosis from 78% to 24%.
- Exercise-induced coronary vasoconstriction in stenotic segments decreased significantly after PTCA (-28% to -4%).
- Pulmonary artery pressure during exercise was lower post-PTCA.
Conclusions:
- Successful PTCA improves coronary vasomotion in patients with CAD.
- Exercise-induced vasoconstriction of diseased coronary segments is reduced post-PTCA.
- PTCA favorably impacts the dynamic response of coronary arteries to stress.
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