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European Heart Journal 1994 15(1):61-67;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Temporal variability and correlation with geometric parameters in vasospastic angina: a quantitative angiographic study

Y. OZAKI, D. KEANE, J. HAASE, J. BAPTISTA, N. MANEVEAU, P. J. DE FEYTER, F. TAKATSU* and P. W. SERRUYS

Department of Interventional cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands
*Division of Cardiology Anjo Kosei Hospital, Anjo, Japan

Received 29 April 1993; revised 6 August 1993; .

Correspondence: Patrick W. Serruys, MD, PhD, FESC, FACC, Department of Interventional Cardiology, Thoraxcenter, Erasmus University, PO Box 1738, 3000 DR Rotterdam, The Netherlands

Abstract

Long-term changes in vasocontractility were examined in 23 coronary segments from 20 patients with variant angina using computer-based quantitative coronary angiography and ergonovine provocation tests repeated at an interval of 42 ± 14 months. Measurements of vasospasticity at the sites of fixed stenoses were compared with values predicted by an elementary geometric theory based on the assumption that the cross-sectional area of a vessel wall is constant regardless of its state of vasoconstriction. While all patients were symptomatic initially, only 11 remained symptomatic at follow-up. At the initial provocation test, the response was correctly predicted in four segments, was lower than expected in one, and was stronger in 18. At follow-up, only one of the four segments in which the response had been initially predicted correctly again showed the predicted response and the remaining three showed a response weaker than expected; the one segment which was initially hypocontractile remained hypocontractile at follow-up; and of the 18 segments which were initially hypercontractile, 12 exhibited hypercontractility again, four had the predicted value and the remaining two showed hypocontractility. In one one of 23 segments did the geometric theory predict the behaviour of vasospasticity at the site of fixed stenosis on both tests. Vasospastic responsiveness is a dynamic process demonstrating temporal variability and is not directly predicted by geometric theory.

Key Words: Coronary spasm • variant angina • geometric theory • ergonovine provocation test


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Y. Ozaki, D. Keane, and P. W. Serruys
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[Abstract] [Full Text]


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