Role of Vasospasm in Acute Coronary Syndrome-Insights From Ergonovine Stress Echocardiography-

Kim, Moo Hyun; Park, En Hee; Yang, Doo Kyung; Park, Tae Ho; Kim, Pil Joo; Yoon, Jin Hyuk; Soo, Kwang; Kum, Dong Sung; Kim, Hye Jin; Kim, Jong Seong

doi:10.1253/circj.69.39

Cited by 27 publications

(10 citation statements)

References 16 publications

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“…Its level is used as a pointer of chronic inflammatory disorders. 5 At high places, it was observed an increase in interleukin-6 and CRP beside all markers of inflammatory levels in serum of healthy volunteers. 6 Hypoxia has an imperative function in triggering VEGF, which amplifies vasculogenesis and angiogenesis to reinstate oxygen in the organs throughout low oxygen tension.…”

Section: Introductionmentioning

confidence: 97%

Manipulation of Quercetin and Melatonin in the Down-Regulation of HIF-1α, HSP-70 and VEGF Pathways in Rat’s Kidneys Induced by Hypoxic Stress

et al. 2020

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Hypoxia may lead to inflammatory responses by numerous signaling pathways. This investigation intended to inspect the defensive role of Quercetin (Quer) and/ or Melatonin (Mel) against reno toxicity induced by Sodium nitrite (Sod ntr). Sod ntr injection significantly decreased blood hemoglobin concentration (Hb) with a concurrent increase in serum tumor necrosis factor- α, interleukin-6, C-reactive protein, creatinine, and urea levels. Over protein-expression of vascular endothelial growth factor and heat shock, protein-70 and mRNA of HIF-1α were also observed. Pretreatment of the Sod ntr- injected rats with the aforementioned antioxidants; either alone or together significantly improved such parameters. Histopathological examination reinforced the previous results. It was concluded that the combined administration of Quer and Mel may be useful as a potential therapy against renal injury induced by Sod ntr. HIF-1α and HSP-70 are implicated in the induction of hypoxia and its treatment.

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Section: Introductionmentioning

confidence: 97%

Manipulation of Quercetin and Melatonin in the Down-Regulation of HIF-1α, HSP-70 and VEGF Pathways in Rat’s Kidneys Induced by Hypoxic Stress

et al. 2020

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“…What cardiologists are concerned of the most might be mortality associated with intractable spasm. One case of cardiac arrest during ErgECHO was reported 12) ; however, thus far, ErgECHO test-related mortality has been scarcely reported. The incidence of fatal ErgECHO complications (0.3%) appears to be similar to that of dobutamine stress echocardiography, which is commonly used for the diagnosis of coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina and Its Prognostic Implications in 3,094 Consecutive Patients

Song

Lee

et al. 2018

Korean Circ J

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Background and ObjectivesErgonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population.MethodsWe studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed.ResultsThe overall positive rate of ErgECHO was 8.6%. No procedure-related mortality or myocardial infarction (MI) occurred. Nineteen patients (0.6%) had transient symptomatic complications during ErgECHO including one who was successfully resuscitated. Cumulative major adverse cardiac events (MACEs) occurred in 14.0% and 5.1% of the patients with positive and negative ErgECHO results, respectively (p<0.001) at a median follow-up of 10.5 years. Cox regression survival analyses revealed that male sex, age, presence of diabetes, total cholesterol level of >220 mg/dL, and positive ErgECHO result itself were independent factors associated with MACEs.ConclusionsErgECHO can be performed safely by experienced physicians and its positive result may be an independent risk factor for long-term adverse outcomes. It may also be an alternative tool to invasive ergonovine-provoked coronary angiography for the diagnosis of vasospastic angina.

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“…Although intracoronary imaging tests can definitely detect spastic changes, and provide some valuable information of the specifics of spastic lesions, their obvious shortcoming is their invasive approach. Thus, applying a noninvasive alternative like echocardiography for spasm detection could advance the detection process [22]. Here, we focus on noninvasive imaging spasm diagnostics with MCTA, which provides no information concerning spastic plaque characteristics.…”

Section: Discussionmentioning

confidence: 99%

Assessing Vessel Tone during Coronary Artery Spasm by Dual-Acquisition Multidetector Computed Tomography Angiography

Jin

Kim²,

Kang

et al. 2017

Cardiology

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Background: Diminished vascular tone is an established biomarker of heart damage. Little is known about the extent of coronary vessel tone (CVT) with spasm as assessed by dual-acquisition multidetector computed tomography angiography (MCTA) in patients with vasospastic angina (VSA). Objective: We evaluated the CVT modulated by intravenous nitrate injection (INI) using MCTA imaging in VSA patients. Methods: Twenty-one VSA patients (60 ± 9 years; 76% males) who underwent initial MCTA (without morning vasodilation), followed by an intracoronary ergonovine provocation test were included. Within 3 days after the initial MCTA patients received INI followed by 28-vessel segment spasm analyzed by MCTA 3D software, applying the following formula as the definition of CVT index (CVTI): (CSA_{IV nitrate} - CSA_initial/CSA_{IV nitrate}) ×100 %, where CSA is the cross-sectional area. Results: Compared to the initial MCTA measures, the INI provocation resulted in the significant increase of average diameter and CSA at the spasm site (2.60 mm [2.11-3.16] vs. 1.42 mm [1.13-2.13]; 5.37 mm² [3.67-7.54] vs. 1.62 mm² [1.02-3.02]; p < 0.001). The CVTI at the spastic segments was higher than at the proximal reference segments (41.0% [21.8-52.3] vs. 18.8% [5.9-26.6] for CVTI diameter; 65.1% [38.6-77.0] vs. 33.9% [5.2-48.1] for CVTI CSA, respectively). To predict VSA, the cut-off value for CVTI diameter was 38.6% (AUC 0.777; 95% CI 0.653-0.901) and 62.5% (AUC 0.779; 95% CI 0.657-0.902) for CVTI CSA in a receiver-operating characteristic curve analysis, with 57.1% sensitivity and 92.9% specificity. Conclusions: This novel imaging technique for assessing CVT by dual-acquisition MCTA after applying INI provocation is suitable for the detection of coronary artery spasm in patients with VSA.

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Role of Vasospasm in Acute Coronary Syndrome-Insights From Ergonovine Stress Echocardiography-

Cited by 27 publications

References 16 publications

Manipulation of Quercetin and Melatonin in the Down-Regulation of HIF-1α, HSP-70 and VEGF Pathways in Rat’s Kidneys Induced by Hypoxic Stress

Manipulation of Quercetin and Melatonin in the Down-Regulation of HIF-1α, HSP-70 and VEGF Pathways in Rat’s Kidneys Induced by Hypoxic Stress

Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina and Its Prognostic Implications in 3,094 Consecutive Patients

Assessing Vessel Tone during Coronary Artery Spasm by Dual-Acquisition Multidetector Computed Tomography Angiography

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