Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Both endothelium-dependent and endothelium-independent function is impaired in patients with angina pectoris and normal coronary angiograms
Regional Cardiac Unit, Papworth Hospital, Papworth Everard Cambridge, U.K.
revised 19 February 1996; accepted 26 February 1996.
Correspondence: Dr A. Chauhan, Laurel Cardiology, 865 West 10th Avenue, Vancouver, British Columbia V5Z IL7, Canada
Abstract
Background The aim of this study was to investigate both endothelium-dependent and endothelium-independent vasodilatation in syndrome X patients. Recently selective impairment of endothelium-dependent function has been reported in a small number of syndrome X patients. However, other investigators have reported impaired endothelium-independent function.
Methods We infused the endothelium-independent vasodilators papaverine and glyceryl trinitrate, and endothelium-dependent vasodilator acetyicholine in the left coronary artery of 35 patients with syndrome X and in 17 control subjects (atypical chest pain, negative exercise test, and normal coronary angiograms). Coronary blood flow was measured with an intracoronary Doppler catheter positioned in the proximal left anterior descending coronary artery, and the artery diameter was assessed using quantitative coronary angiography.
Result The mean increase in coronary blood flow in response to a 12 mg dose of papaverine was significantly less in the syndrome X group (185±74% vs 411 ± 59%, P0·001). The increase in coronary blood flow in response to acetylcholine, at doses of 1, 3, 10, and 30 µg. min–1, was also significantly lower in the syndrome X group (12±13 (P>0·05), 41 ± 33, 57 ± 68, and 124 ± 87% (P>0·001)) as compared to the control group (76 ± 49, 214 ± 116, 355 ± 115, and 361 ± 74%).
Conclusion These findings demonstrate that both endothelium-dependent and endothelium-independent dilatation of the coronary microvasculature is impaired in syndrome X.
Key Words: Syndrome X • endothelial function • papaverine • acetylcholine • coronary blood flow
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