Document Detail


Severity of Myocardial Fatty Acid Dysmetabolism Induced by Coronary Spasm Does not Differ With Thrombolysis in Myocardial Infarction (TIMI) Grade During Intracoronary Acetylcholine Provocation Tests.
MedLine Citation:
PMID:  25088582     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Whether additional intracoronary acetylcholine (ACH) injections are required for severe coronary spasm without limited coronary flow in the ACH provocation test remains unclear. We used (123)I-β-methyl-iodophenyl pentadecanoic acid ((123)I-BMIPP) to identify myocardial ischemic memory to compare the severity of myocardial fatty acid dysmetabolism among Thrombolysis in Myocardial Infarction (TIMI) grade flow.Thirteen hypertensive volunteers (mean age, 69.5 years) and 37 patients with VSA (mean age, 62.8 years) were enrolled. The patients with VSA were stratified according to TIMI flow grades of 3 (90% luminal narrowing; n = 12) or TIMI 0-2 (≥ 99% or total occlusion; n = 25) during ACH provocation tests. Two weeks after cardiac catheterization, (123)I-BMIPP myocardial scintigraphic images were obtained at 15 minutes (early) and at 4 hours (delayed) after tracer injection. The heart-to-mediastinum (H/M) ratio and washout rates (WR) were calculated from planar images.The TIMI 3 and TIMI 0-2 groups had significantly lower early and delayed H/M ratios than controls but the difference did not reach significance between the two groups (Early: 2.7 ± 0.5 versus 2.3 ± 0.4 and 2.2 ± 0.3, P = 0.024; Delayed: 2.4 ± 0.4 versus 1.8 ± 0.3 and 1.8 ± 0.3, P = 0.001). The washout rate was greater for TIMI 0-2 than the controls.The severity of myocardial fatty acid dysmetabolism did not differ between TIMI 3 and TIMI 0-2 coronary spasms. Additional ACH might not be required considering safety and the severity of coronary spams with TIMI 3 grade flow.
Authors:
Kihei Yoneyama; Yoshihiro J Akashi; Kohei Ashikaga; Keisuke Kida; Yukio Sato; Maya Tsukahara; Marika Yamada; Yasushi Takagi; Ryo Kamijima; Kengo Suzuki; Haruki Musha; Tomoo Harada
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-04
Journal Detail:
Title:  International heart journal     Volume:  -     ISSN:  1349-3299     ISO Abbreviation:  Int Heart J     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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