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[Role of the vasospastic factor in stenocardia in ischemic heart disease]

V S Gasilin, B A Sidorenko, A A Kramer

    Kardiologiia
    |February 1, 1982
    PubMed

    Insights

    This study reveals that vasospastic angina pectoris can coexist with other forms, impacting myocardial ischemia localization. Different treatments are effective based on ST-segment changes during angina attacks.

    Area of Science:

    • Cardiology
    • Clinical Pharmacology

    Background:

    • Coronary artery disease diagnosis and management.
    • Understanding different forms of angina pectoris.

    Purpose of the Study:

    • To differentiate vasospastic angina pectoris from other forms.
    • To investigate the localization of myocardial ischemia.
    • To evaluate drug efficacy based on angina presentation.

    Main Methods:

    • Selective coronarography in 100 patients.
    • Pharmacological testing with intravenous ergometrine.
    • Myocardial scintigraphy with 201Tl.
    • Echocardiography during anginal attacks.

    Main Results:

    • Ergometrine test identifies vasospastic angina, irrespective of coronary lesions or exercise tolerance.
    • Discrepancies in ischemic zone localization between exercise and ergometrine tests suggest dual angina forms.
    • ST-segment elevation during angina shows greater left ventricular dilatation and reduced contractility compared to ST-segment depression.
    • Corinfar effective for ST-segment elevation angina; Inderal ineffective.
    • No difference between Corinfar and Inderal for ST-segment depression angina.

    Conclusions:

    • Vasospastic angina pectoris can coexist with other forms, presenting distinct pathogenetic mechanisms and ischemic localization.
    • Echocardiographic findings differ between ST-segment elevation and depression angina.
    • Treatment strategies for angina should consider the specific ECG presentation and underlying mechanisms.

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