Assessment of coronary vasomotor responses to acetylcholine in German and Japanese patients with epicardial coronary spasm—more similarities than differences?
| Autor: | Akira Suda, Udo Sechtem, Koichi Sato, Yuji Odaka, Giancarlo Pirozzolo, Anastasios Athanasiadis, Hiroaki Shimokawa, Peter Ong, Raffi Bekeredjian, Kiyotaka Hao, Jun Takahashi, Andreas Seitz |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Vasodilator Agents Coronary Vasospasm 030204 cardiovascular system & hematology Coronary Angiography Ventricular Function Left Angina 03 medical and health sciences 0302 clinical medicine Japan Germany Internal medicine Prevalence otorhinolaryngologic diseases medicine Humans cardiovascular diseases 030212 general & internal medicine Ejection fraction Vasomotor business.industry Gender distribution Stroke Volume Middle Aged Vascular surgery medicine.disease Coronary Vessels Acetylcholine nervous system diseases Cardiac surgery body regions Coronary arteries stomatognathic diseases medicine.anatomical_structure Injections Intra-Arterial Vasoconstriction Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Heart and Vessels. 36:337-344 |
| ISSN: | 1615-2573 0910-8327 |
| Popis: | Coronary spasm is an established cause for angina pectoris. Ethnic differences have been suggested among Asian compared to Caucasian patients regarding prevalence, gender distribution, and angiographic patterns of coronary spasm. The aim of this study was to compare contemporary German and Japanese patients with coronary spasm. Between 2011 and 2015, 149 patients with resting angina and unobstructed coronary arteries with acetylcholine-induced epicardial spasm were enrolled in Stuttgart, Germany (n = 69) and Sendai, Japan (n = 80). All patients underwent intracoronary acetylcholine testing according to a standardized protocol. Comprehensive analysis included type of spasm (focal/diffuse), dose of acetylcholine leading to spasm, and frequency of multivessel spasm. Patients in this study were 61 ± 11 years old, predominantly female (54%), and had normal left ventricular ejection fraction (73 ± 9%). Diffuse spasm was the most prevalent type of spasm (85%) whereas focal spasm was found in the remaining 15% of patients. 31% of patients had multivessel spasm. Comparing the German with the Japanese patients, distribution of spasm type (focal/diffuse, p = 0.19) and frequency of multivessel spasm (p = 0.22) were comparable. Moreover, when Japanese patients were compared with German patients and diffuse spasm with focal spasm patients, respectively, no significant differences were observed regarding the acetylcholine dose required to induce spasm (p = 0.078 and p = 0.46, respectively). In conclusion, diffuse epicardial coronary spasm is the most frequent finding among German and Japanese patients with resting angina, unobstructed coronary arteries, and epicardial spasm on acetylcholine testing. Japanese and German patients share several similarities including comparable types of spasm and frequency of multivessel spasm. |
| Databáze: | OpenAIRE |
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