冠攣縮性狭心症におけるアセチルコリン負荷試験の攣縮再現性に関する検討

概要

論文の詳細を見る
To assess the reproducibility of coronary vasospasm with acetylcholine provocation test, 23 patients of vasospastic angina without significant stenosis were reexamined at intervals of 5. 5 ± 0.8 years. According to the response to medical treatment, 23 patients were divided into 2 groups, group A (8, angina resolved) and group B (15, angina persisted). Sixty-four segments were defined as spastic, demonstrating more than 90% narrowing after acetylcholine injection at the initial angiogram. On these segments, the degree of spasticity and the type of spasm (diffuse or focal) were compared between the initial and follow-up study. Of the 64 segments, 55 (86%) still had some spasticity at the follow-up study and 28 (44%) showed similar spasticity, that is, more than 90% narrowing, while in only 9 (14%) segments spasm was not re-provoked. As to the spasticity of more than 90% narrowing, group B showed significantly higher reproducibility than group A (100% in group B vs. 63% in group A, p=0.01). The reproducibility according to the type of the spasm provoked was 84%. Acetylcholine provocation test has high reproducibility in patients with vasospastic angina, and the provocability of spasm was significantly associated with the disease activity.
1996-10-25