Document Detail

Provocation of microvessel spasm by low-dose acetylcholine in patients with suspected coronary artery disease--two case reports.
MedLine Citation:
PMID:  15793610     Owner:  NLM     Status:  MEDLINE    
Endothelial dysfunction plays an important role in the pathogenesis of cardiac syndrome X, and intracoronary low-dose acetylcholine infusion is a widely used diagnostic modality for studying the coronary artery endothelial function. The authors herein report 2 cases of cardiac syndrome X with coronary artery endothelial dysfunction and microvessel spasm. The findings of non-invasive testing were positive for ischemia. Coronary angiograms appeared entirely normal in both cases. However, the intracoronary infusion of low-dose (1.5-15 microg/minute) acetylcholine demonstrated an impairment of the coronary blood flow response and consequently provoked an ST-segment elevation in an electrocardiogram. The coronary angiograms showed no spasm in the epicardial arteries. These patients are thus suggested to have cardiac syndrome X with microvessel spasms associated with coronary artery endothelial dysfunction.
Nobuyuki Masaki; Bonpei Takase; Kimio Satomura; Takashi Akima; Yoshihiro Matsushima; Haruhiko Hosaka; Akira Hamabe; Akira Kurita; Fumitaka Ohsuzu
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Angiology     Volume:  56     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-03-28     Completed Date:  2005-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  211-6     Citation Subset:  IM    
The First Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
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MeSH Terms
Acetylcholine / diagnostic use*
Blood Flow Velocity / drug effects
Cholinergic Agents / diagnostic use*
Coronary Angiography
Coronary Circulation / drug effects,  physiology
Coronary Disease / diagnosis*,  physiopathology
Coronary Vasospasm / chemically induced*,  physiopathology
Diagnosis, Differential
Dose-Response Relationship, Drug
Endothelium, Vascular / drug effects,  physiopathology
Injections, Intra-Arterial
Magnetic Resonance Angiography
Microcirculation / drug effects,  physiopathology
Microvascular Angina / diagnosis*,  physiopathology
Middle Aged
Reg. No./Substance:
0/Cholinergic Agents; 51-84-3/Acetylcholine

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