Coronary Vasomotor Response to Acetylcholine Late After Angioplasty

概要

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To elucidate the changes in coronary vasomotion in a preiously balloon-dilated segment, we exanined the vasoconstricting response of previously balloon-dilated and non-dilated segments to acetylcholine. Acetylcholin was administered into the coronary arteries cumulatively (left and right coronary artery: 10-100μg) in 15 patients (age: 60±3 years, 12 males and 3 females) at 7.4±1.5 months after successful percutaneous transluminal coronary angioplasty (PTCA). In PTCA segments with no restenosis, dose-dependent constriction in response to acetylcholin was observed in only 1 patient. In non-PTCA segments of PTCA and non-PTCA arteries, 12 patients showed dose-dependent vasoconstriction in response to acetylcholine. Coronary spasm, which was defined as a more than 75% reduction in coronary diameter compared with that after isosorbide dinitrate, was provoked in one PTCA segment (7%). In non-PTCA segments of PTCA and non-PTCA arteries, 15 of 44 arteries (34%) demonstrated coronary spasm in 9 of 15 patients (60%, p<0.005 vs PTCA segment). In conclusion, PTCA segments free of restenosis showed no hyper-reactivity to acetylcholine, while non-PTCA segments showed hypercontractility in response to acetylcholine. Coronary balloon angioplasty may alter the coronary vasomotor reaction to acetylcholine several months after angioplasty.
社団法人日本循環器学会の論文
1996-09-20