J Korean Med Sci.  2005 Apr;20(2):204-208. 10.3346/jkms.2005.20.2.204.

Changes of Coronary Blood Flow in Vasospastic Angina under Cold Stimulation by Transthoracic Doppler Echocardiography

• Park SM
• Shim WJ
• Ahn JC
• Lim DS
• Kim YH
• Ro YM

• KMID: 1095190
• DOI: http://doi.org/10.3346/jkms.2005.20.2.204

Abstract

This study was done to evaluate changes of microvascular function under cold stimulation by measuring coronary flow velocities (CFVs) in vasospastic angina (VA) patients using transthoracic Doppler echocardiography (TTDE). 14 patients with VA and 15 healthy controls were included. CFVs were measured at the distal left anterior descending coronary artery by TTDE at baseline and under cold stimulation. Hyperemia was induced by intravenous adenosine infusion (140 microgram/kg/min). At baseline, CFVs and coronary flow reserve (CFR) were not different between controls and VA patients. Under cold stimulation, the degree of increment of CFV with adenosine was lower in VA patients than in controls. Comparing baseline with cold stimulation, coronary flow reserve (CFR) increased (3.1 +/-0.7 to 3.8 +/-1.0, p=0.06) in controls. In contrast, in VA patients, CFR was decreased (2.8 +/-0.9 to 2.6 +/-0.7, p=0.05) and coronary vascular resistance index markedly increased (0.35 to 0.43, p=0.01). Throughout the study, no patient experienced chest pain or ECG changes. In VA patients, CFR was preserved at baseline, but coronary blood flow increase in response to cold stimulation was blunted and CFR was decreased. These findings suggest that endothelial dependent vasodilation is impaired at the coronary microvascular and the epicardial artery level in VA under cold stimulation.

Keyword

Angina Pectoris, Variant; Coronary Vasospasm; Cold Stimulation; Regional Blood Flow; Microvascular Function; Echocardiography, Doppler

MeSH Terms

Adult
Aged
Angina Pectoris/*physiopathology/ultrasonography
Cold
*Coronary Circulation
*Echocardiography, Doppler
Female
Humans
Male
Microcirculation/physiopathology
Middle Aged

Figure

• 

  Fig. 1 Study protocol. CFR, coronary flow reserve; CFV, coronary blood flow velocity.

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