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The effects of ergonovine maleate on coronary arterial size
Insights
Ergonovine maleate causes coronary artery narrowing, a normal response independent of nerve control. This vasoconstrictor effect was observed in patients with angina and heart transplant recipients without coronary spasm.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery size changes can be induced by ergonovine maleate.
- Understanding these changes is crucial for diagnosing and managing various chest pain syndromes.
Purpose of the Study:
- To describe and quantify coronary arterial diameter changes induced by ergonovine maleate.
- To differentiate between normal pharmacologic response and coronary artery spasm.
Main Methods:
- Evaluated 90 patients, including those with typical angina, atypical chest pain, variant angina, and heart transplant recipients.
- Administered serial bolus injections of ergonovine maleate (0.05 mg, 0.10 mg, 0.25 mg).
- Quantified angiographic changes in coronary artery diameter, noting spasm versus normal vasoconstriction.
Main Results:
- Normal pharmacologic response (mild, diffuse narrowing) occurred in 72 patients without spasm, with narrowing increasing with dose (10-20%).
- Coronary artery spasm was defined as marked (greater than 85%) focal or diffuse narrowing.
- The degree of normal narrowing was consistent between heart transplant recipients and patients with normally innervated hearts.
Conclusions:
- Ergonovine maleate elicits a direct vasoconstrictor response in coronary arteries.
- This normal response is independent of neural control extrinsic to the heart.
- The findings aid in distinguishing drug-induced vasoconstriction from pathological coronary spasm.
Abstract:
Changes in coronary arterial size due to ergonovine maleate are described and quantitated in 90 patients--18 with typical angina pectoris, 56 with atypical chest pain, nine with variant angina pectoris, and seven heart transplant (allograft) recipients. We observed two angiographic changes in the diameter of coronary arteries: 1) spasm, which was characterized by occlusion or marked (greater than 85%) focal or diffuse vessel narrowing, or 2) relatively mild and diffuse vessel narrowing, which was interpreted as the normal pharmacologic response to the drug. Serial bolus injections of 0.05 mg, 0.10 mg and 0.25 mg of ergonovine maleate produced diffuse narrowing of the diameter of coronary arteries of 10 +/- 1.5%, 16 +/- 1.4% and 20 +/- 1.3% (mean +/- SEM), respectively, in the 72 patients with anginal syndromes who did not develop coronary spasm. The degree of coronary arterial narrowing was the same in heart transplant recipients and in patients with normally innervated hearts who did not develop coronary spasm. We believe the normal pharmacologic response to ergonovine maleate was due to a direct vasoconstrictor action of the drug; this action was independent of neural control extrinsic to the heart.