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Updated: Apr 10, 2026
Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm
Published on: September 17, 2021
Time-Dependent Analysis of Blood Sampling to Detect Metabolic Ischemia - Serial Coronary Artery-Coronary Sinus
Tsuyoshi Ito1, Masashi Yokoi1, Shuichi Kitada1
1Department of Cardiology, Nagoya City University.
Background:
The optimal timing for lactate sampling during acetylcholine (ACh) provocation to detect metabolic ischemia remains unclear.
Methods And Results:
In 20 patients with suspected INOCA, blood samples from the coronary artery and coronary sinus were obtained at baseline, every minute for 5 min after ACh, and after nitroglycerin. Metabolic ischemia (negative lactate extraction ratio) occurred in 12 patients: 10 patients exhibited ischemia at 1 min, and 2 patients only at 2 min. No ischemia was observed beyond 3 min.
Conclusions:
Sampling at both 1 and 2 min may reduce false-negative detection of metabolic ischemia during ACh provocation.
