Coronary angiography during exercise-induced angina with ECG changes

Matsuda, Yasuo; Moritani, Kohshiro; Fujii, Takashi; Yoshino, Fumio; Katayama, Kazuhiro; Miura, Toshiro; Toma, Yoichi; Matsuda, Masako; Kusukawa, Reizo

doi:10.1016/0002-8703(84)90461-7

Cited by 23 publications

(2 citation statements)

References 31 publications

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“…Auffallend war jedoch ein erh6hter basaler Gef~igtonus. Andere Studien hatten zuvor gezeigt, das die Gef~i6regulation unter Belastungsbedingungen im Bereich der Plaques entweder keine Anderung [54] oder eine erh6hte Vasokonstriktion aufwies [28,31]. Eine Untersuchung zur Endothelfunktion mit Acetylcholin konnte die zuvor geschilderten Ergebnisse best~itigen [69].…”

Section: Untersuchungen Zur Endotheifunktion Beim Akuten Koronarsyndromunclassified

Endotheliale Funktionsstörung bei Patienten mit akutem Koronarsyndrom

Fichtlscherer

Zeiher

1999

Herz

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Increased vasoconstriction, activation of platelet vessel wall interaction and invasion of monocytes into the subintima as well as vascular smooth muscle cell proliferation play a fundamental role in the pathogenesis of coronary artery disease. Acute coronary syndromes such as myocardial infarction and unstable angina pectoris are characterized by plaque rupture or erosion, activation of platelets and the coagulation system and vasoconstriction. Endothelial dysfunction may be one of the underlying mechanisms linking coronary artery disease and acute coronary syndromes. Both of these are often temporarily limited. Therefore, "non-invasive examination" of endothelial function by venous occlusion plethysmography or high resolution ultrasound might be useful for monitoring high-risk patients.

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Section: Untersuchungen Zur Endotheifunktion Beim Akuten Koronarsyndromunclassified

Endotheliale Funktionsstörung bei Patienten mit akutem Koronarsyndrom

Fichtlscherer

Zeiher

1999

Herz

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“…It is a well established fact that spasm of the coronary arteries may cause angina pectoris at rest associated with either ST segment elevation or depression (1-3). Recent angiographic studies have shown that coronary vasoconstriction may also be brought on by physical exercise (4)(5)(6), especially when the resting coronary artery tone is high (7). Hill et al (8) have demonstrated a high basal tone of coronary arteries with proven vasospastic activity.…”

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Exercise Stress Testing in Angina Patients with Positive Response to Hyperventilation Testing: Influence of the Coronary Artery Tone

Rasmussen

Engby

Bagger

et al. 1986

Journal of Internal Medicine

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We studied the exercise stress test and the coronary artery tone in two groups of angina patients with comparable coronary atherosclerosis. Group I (20 males and 5 females, mean age 53.5 years) with a positive, and group 11 (22 males and 3 females, mean age 52.5 years) with a negative response to the hyperventilation test (HVT). A positive exercise stress test (ST depression ≥1 mm) was found in 24 patients in group 1 vs. 15 in group II (p<0.01), despite a lower maximal rate pressure product (198±11.2 vs. 236±10.1, p<0.05) and maximal work load (110 W±7.1 vs. 136±7.4 W, p<0.02) in group I. A high coronary artery tone (dilatation (DIL %) of the coronary arteries after nitroglycerin ≥ 10%) was found in 18 patients in group I and in 4 in group II (p<0.01). DIL % was 22.6±3.8 vs. 5.8±1.4 in groups I and II, respectively (p<0.005). DIL% was significantly related to persistence of ST depression after exercise (r=0.36, p<0.05), and 21 of 22 patients with high tone had a positive exercise stress test vs. 18 of 28 with low tone (p<0.05). These findings suggest that the coronary artery tone influences the response to exercise in some patients with angina. Since the patients in group I were identified by HVT, our results underline the clinical relevance of this test.

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Ergonovine maleate test detects anginal patients with poorly reproducible exercise tests

Brunelli

Spallarossa

Ghigliotti

et al. 1990

Clinical Cardiology

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The aim of the study is to evaluate the reproductability of exercise testing and to determine whether there any correlation between the reproducibility of exercise and response to the ergonovine maleate test. Thirty‐ patients with mixed angina and documented artery disease underwent an ergonovine maleate test four exercise tests on consecutive days in the same conditions. The ergonovine test was positive in 20 patients (Group I) and negative in 18 patients (Group II). There were no significant differences in the clinical and angiographic data of the two groups. All 152 exercise tests were positive. The variability of the response of the repeated tests was assessed by means of an analysis of the following parameters: heart rate, blood pressure, rate‐pressure product, watts, and minutes were recorded at the onset of ischemia (ST| ≥ 0.1 mV). Range (maximal‐minimal obtained value), ratio between range and maximal obtained value, and coefficient of variation (standard deviation/mean of the four parameters) were calculated for each patient. The analysis of these values demonstrated that while the test was reproducible in some patients, a high individual variability was present in others. Moreover, the individual variability results were higher in Group I than in Group II, with a statistically significant difference for all considered parameters. In conclusion, it is possible to have a poorly reproducible exercise test in patients with mixed angina. The correlation between a positive ergonovine test and a poorly reporducible exercise test suggests that abnormal coronary vasomotion may sometimes be present during exercise and may affect the reproducibility of the test.

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Coronary angiography during exercise-induced angina with ECG changes

Cited by 23 publications

References 31 publications

Endotheliale Funktionsstörung bei Patienten mit akutem Koronarsyndrom

Endotheliale Funktionsstörung bei Patienten mit akutem Koronarsyndrom

Exercise Stress Testing in Angina Patients with Positive Response to Hyperventilation Testing: Influence of the Coronary Artery Tone

Ergonovine maleate test detects anginal patients with poorly reproducible exercise tests

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