Coincidence between spontaneous and inducible coronary spasm: acetylcholine test is clinically valued for diagnosing coronary spasm.
Aged
Aged, 80 and over
Coronary Angiography
/ methods
Coronary Vasospasm
/ diagnosis
Coronary Vessels
/ diagnostic imaging
Female
Follow-Up Studies
Humans
Injections, Intra-Arterial
Male
Middle Aged
Nitroglycerin
/ administration & dosage
Retrospective Studies
Vasodilator Agents
/ administration & dosage
Acetylcholine
Coincidence
Positive spasm
Spontaneous spasm
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
04
09
2020
accepted:
27
11
2020
pubmed:
4
1
2021
medline:
30
9
2021
entrez:
3
1
2021
Statut:
ppublish
Résumé
There is no report regarding the correlation between spontaneous documented coronary spasm and acetylcholine (ACh)-inducible spasm. We retrospectively analyzed the coincidence between angiographical spontaneous coronary spasm and ACh-inducible spasm in the same patients. We recruited 28 patients with 30 angiographical spontaneous coronary spasm in 6009 patients with diagnostic and follow-up coronary arteriography from Jan 1991 and Mar 2019 in the cardiac catheterization laboratory. We could perform intracoronary ACh testing in 19 patients with 20 vessels. ACh was injected in incremental dose of 20/50/100 μg into the left coronary artery and 20/50/80 μg into the right coronary artery. Positive spasm was defined as > 90% stenosis and ischemic ECG changes. Angiographical documented spontaneous coronary spasm was observed in 0.47% (28/6009) of patients with diagnostic and follow-up coronary angiography. Intracoronary administration of ACh reproduced 15 spontaneous coronary spasm and no provoked spasm was observed in the remaining 5 vessels due to the administration of nitroglycerine or under medications. Spasm-provoked sites by ACh tests and ACh-inducible spasm configurations were almost similar to spontaneous spasm. Coincidence of provoked spasm site (93.3% vs. 6.7%, p < 0.001) and spasm configuration (93.3% vs. 6.7%, p < 0.001) was markedly higher than discordance. Intracoronary ACh testing can reproduce spontaneous coronary artery spasm in 75% of vessels with almost similar sites and same morphological characteristics irrespective of the administration of nitroglycerine or vasodilators. ACh test is a reliable method to document coronary artery spasm in the clinic.
Identifiants
pubmed: 33389065
doi: 10.1007/s00380-020-01748-0
pii: 10.1007/s00380-020-01748-0
doi:
Substances chimiques
Vasodilator Agents
0
Nitroglycerin
G59M7S0WS3
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
749-755Références
Kanazawa K, Suematsu M, Ishida T, Hirata K, Kawashima S, Akita H, Yokoyama M (1997) Disparity between serotonin- and acetylcholine-provoked coronary artery spasm. Clin Cardiol 20:146–152
doi: 10.1002/clc.4960200212
Sueda S, Kohno H, Fukuda H, Ochi N, Kawada H, Hayashi Y, Uraoka T (2003) Induction of coronary artery response by two pharmacological agents: comparison between intracoronary injection of acetylcholine and ergonovine. Coron Artery Dis 14:451–457
doi: 10.1097/00019501-200309000-00006
Suzuki Y, Tokunaga S, Ikeguchi S, Miki S, Iwase T, Tomita T, Murakami T, Kawai C (1992) induction of coronary artery spasm by intracoronary acetylcholine: comparison with intracoronary ergonovine. Am Heart J 124:39–47
doi: 10.1016/0002-8703(92)90918-L
Yasue H, Horio Y, Nakamura N, Fujii H, Imoto N, Sonoda R, Kugiyama K, Obata K, Morikami Y, Kimura T (1986) Induction of coronary artery spasm by acetylcholine in patients with variant angina : possible role of the parasympathetic nervous system in the pathogenesis of coronary artery spasm. Circulation 74:955–963
doi: 10.1161/01.CIR.74.5.955
Okumura K, Yasue H, Matsuyama K, Goto K, Miyagi H, Ogawa H, Matsuyama K (1988) Sensitivity and specificity of intracoronary injection of acetylcholine for the induction of coronary artery spasm. J Am Coll Cardiol 12:883–888
doi: 10.1016/0735-1097(88)90449-4
Okumura K, Yasue H, Horio Y, Takaoka K, Matsuyama K, Kugiyama K, Fujii H, Morikami Y (1988) Multivessel coronary spasm in patients with variant angina: a study with intracoronary injection of acetylcholine. Circulation 77:535–542
doi: 10.1161/01.CIR.77.3.535
Curry RC Jr, Pepine CJ, Sabon MB, Conti R (1979) Similarities of ergonovine-induced and spontaneous attacks of variant angina. Circulation 59:307–312
doi: 10.1161/01.CIR.59.2.307
Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, Shimokawa H, Merz NB, on behalf of the Coronary Vasomotion Disorders International Study Group (COVADIS) (2017) International standardization of diagnostic criteria for vasospastic angina. Eur Heart J 38:2565–2568
pubmed: 26245334
JCS joint working group (2014) Guidelines for diagnosis and treatment of patients with vasospastic angina (Coronary spastic angina). Circ J 78:2779–2801
doi: 10.1253/circj.CJ-66-0098
Scanlon PJ, Faxon DP, Audet AM, Leon DL, Carabello B, Murray JA, Dehmer GJ, Nissen SE, Eagle KA, Pepine CJ, Legako RD, Watson RM, Ritchie JL, Gibbons RJ, Chettlin MD, Russell RO, Eagle KA, Ryan TJ, Gardner TJ, Smith SC Jr, Garson AG Jr (1999) ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography). J Am Coll Cardiol 33:1756–1824
doi: 10.1016/S0735-1097(99)00126-6
Sueda S, Ochi N, Kawada H, Matsuda S, Hayashi Y, Tsuruoka T, Uraoka T (1999) Frequency of provoked coronary vasospasm in patients undergoing coronary arteriography with spasm provocation test of acetylcholine. Am J Cardiol 83:1186–1190
doi: 10.1016/S0002-9149(99)00057-0
Sueda S, Saeki H, Otani T, Mineoi K, Kondou T, Yano K, Ochi T, Ochi N, Hayashi Y, Tsuruoka T, Kawada H, Matsuda S, Uraoka T (2000) Major complications during spasm provocation tests with an intracoronary injection of acetylcholine. Am J Cardiol 85:391–394
doi: 10.1016/S0002-9149(99)00754-7
Sueda S, Fukuda H, Watanabe K, Ochi N, Kawada H, Hayashi Y, Uraoka T (2001) Clinical characteristics and possible mechanism of paroxysmal atrial fibrillation induced by intracoronary injection of acetylcholine. Am J Cardiol 88:570–573
doi: 10.1016/S0002-9149(01)01744-1
Sueda S, Kohno H, Ochi T, Uraoka T (2015) Overview of the acetylcholine spasm provocation test. Clin Cardiol 38:430–438
doi: 10.1002/clc.22403
Sueda S, Kohno H, Ochi T, Uraoka T, Tsunemitus K (2017) Overview of the pharmacological spasm provocation test: comparisons between acetylcholine and ergonvoine. J Cardiol 69:57–65
doi: 10.1016/j.jjcc.2016.09.012
Sueda S, Kohno H (2020) Clinical characteristics in patients with rest angina and hypoplastic right coronary artery. Heart Vessels 35:443–450
doi: 10.1007/s00380-019-01507-w
Sueda S (2020) Pharmacological spasm provocation testing in 2500 patients: provoked spasm incidence, complications, and cardiac events. Heart Vessels 35:1368–1377
doi: 10.1007/s00380-020-01616-x
Ostovan MA, Khanian MS, Hamidi S, Fattahi M, Dehghani P (2016) Spontaneous multi-focal coronary artery spasm: a case report. J Cardiovasc Thorac Res 8:137–139
doi: 10.15171/jcvtr.2016.28
Hung MJ, Hu P, Hung MY (2014) Coronary artery spasm: review and update. Int Med Sci 11:1161–1171
doi: 10.7150/ijms.9623
Hackett D, Larkin S, Cherchia S, Davies G, Kaski JC, Maseri A (1987) Induction of coronary artery spasm by a direct local action of ergonovine. Circulation 75:577–582
doi: 10.1161/01.CIR.75.3.577
Ong P, Athanasiadis A, Borgulya G, Voksi I, Bastiaenen R, Kubik S, Hill S, Schaufele T, Mahrholdt H, Kaski JC, Sechtem U (2014) Clinical usefulness, angiographic characteristics, and safety evaluation of intracoronary acetylcholine provocation testing among 921 consecutive white patients with unobstructed coronary arteries. Circulation 129:1723–1730
doi: 10.1161/CIRCULATIONAHA.113.004096
Aziz A, Hansen HS, Sechtem U, Prescott E, Ong P (2017) Sex-related differences in vasomotor function in patients with angina and unobstructed coronary arteries. J Am Coll Cardiol 70:2349–2358
doi: 10.1016/j.jacc.2017.09.016
Sato K, Kaikita K, Nakayama N, Horio E, Yoshimura H, Ono T, Ohba K, Tsujita K, Kojima S, Tayama S, Hokimoto S, Matsui K, Sugiyama S, Yamabe H, Ogawa H (2013) Coronary vasomotor response to intracoronary acetylcholine injection, clinical features, and long-term prognosis in 873 consecutive patients with coronary spasm: analysis of a single-center study over 20 years. J Am Heart Assoc 2:e000227
doi: 10.1161/JAHA.113.000227
Ishii M, Kaikita K, Sato K, Tanaka T, Sugamura K, Sakamoto K, Izumiya Y, Yamamoto E, Tsujita K, Yamamuro M, Kojima S, Soejima H, Hokimoto S, Matsui K, Ogawa H (2015) Acetylcholine-provoked coronary spasm at site of significant organic stenosis predicts poor prognosis in patients with coronary vasospastic angina. J Am Coll Cardiol 66:1105–1115
doi: 10.1016/j.jacc.2015.06.1324
Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj S (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the Management of Stable Coronary Artery Disease of the European Society of Cardiology [published correction appears in Eur Heart J 2014; 35: 2260–2261]. Eur Heart J 34:2949–3003
doi: 10.1093/eurheartj/eht310.P4876
Anderson JI, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr (2013) 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines [published correction appears in Circulation. 2013; 127: e863–e864]. Circulation 127:e663–e828
doi: 10.1161/CIR.0b013e31828987e5