Effect of acetylcholine on the highly stenotic coronary artery: Difference between the constrictor response of the infarct-related coronary artery and that of the noninfarct-related artery

Abstract

To examine the constrictor response of the infarct-related stenotic coronary artery in comparison with that of noninfarct-related stenotic arteries, acetylcholine in maximal doses of 100 micrograms for the left and 50 micrograms for the right coronary artery was injected into the 16 infarct-related coronary arteries of 16 patients with previous myocardial infarction (group 1) and into 19 stenotic coronary arteries of 16 patients with stable angina without myocardial infarction (group 2). Acetylcholine's effects on lumen diameter and area were quantitatively analyzed at the stenotic segment and its proximal segment without significant stenosis. Acetylcholine decreased lumen diameter and area at the stenotic segments from 0.72 +/- 0.18 to 0.18 +/- 0.33 mm and from 0.45 +/- 0.22 to 0.10 +/- 0.22 mm2, respectively, in group 1 (both p less than 0.01) and from 0.75 +/- 0.22 to 0.49 +/- 0.30 mm and 0.48 +/- 0.29 to 0.26 +/- 0.23 mm2, respectively, in group 2 (both p less than 0.01). Acetylcholine decreased the diameter and area at the proximal segment from 2.71 +/- 0.75 to 2.38 +/- 0.6 mm and from 6.18 +/- 3.4 to 4.71 +/- 2.23 mm2, respectively, in group 1 (both p less than 0.01) and from 2.31 +/- 0.67 to 1.95 +/- 0.59 mm and from 4.5 +/- 2.97 to 3.22 +/- 1.96 mm2, respectively, in group 2 (both p less than 0.01). The changes in diameter and area at the stenotic segment in group 1 were significantly greater than those in group 2 (both p less than 0.01); there were no significant differences between groups in the changes at the proximal segment.(ABSTRACT TRUNCATED AT 250 WORDS)

Magnesium Deficiency in Patients With Recent Myocardial Infarction and Provoked Coronary Artery Spasm

“…Coronary vasospasm is one of the most important triggers of acute coronary syndrome and according to previous reports, 18,19 the frequency of provoked coronary artery spasm in patients with AMI is significantly higher than in controls. Thus, patients with AMI had higher coronary vasoactivity.…”

Endothelial Dysfunction and Cardiovascular Risk Prediction in Peripheral Arterial Disease

“…It is associated with risk factors also in the absence of overt atherosclerosis, 2 promotes progression of the atherosclerotic lesion, 3,4 and is more pronounced in arteries with lesions responsible for acute coronary syndromes. 5,6 Consequently, endothelial function has been defined an "excellent barometer" of vascular health 7 and can be used to gauge cardiovascular risk. In fact, endothelial function, measured as the vasodilating response of resistance or conduit vessels to stimuli that induce release of nitric oxide, 8,9 is related to atherosclerosis-induced clinical events in a variety of cardiovascular conditions.…”

Endothelial dysfunction and coronary artery disease

“…volume 75, (nº 2), 2000 tood. Nevertheless, there is convincing evidence that injury and dysfunction of the endothelium play a pathogenic role in the initial development of atherosclerosis [7][8][9] and, in a more delayed way, in unstable coronary syndromes 10 . Endothelial dysfunction has been associated with diverse risk factors for atherosclerotic disease 11 , including the presence of hypercholesterolemia 12 , smoking 13 , arterial hypertension 14 , diabetes mellitus 15 , family history of premature coronary disease 16 , hyperhomocysteinemia 17 , and aging 18 , even before vascular damage becomes evident.…”

“…In contrast, endothelial dysfunction appears to play a pathogenic role in the initial development of atherosclerosis [7][8][9] and of unstable coronary syndromes 10 , being associated with atherosclerotic disease risk factors [11][12][13][14][15][16][17][18] , and being present even before vascular involvement becomes evident 6,[19][20][21] .…”