High Prevalence of a Pathological Response to Acetylcholine Testing in Patients With Stable Angina Pectoris and Unobstructed Coronary Arteries

Ong, Peter; Athanasiadis, Anastasios; Borgulya, Gábor; Mahrholdt, Heiko; Kaski, Juan Carlos; Sechtem, Udo

doi:10.1016/j.jacc.2011.11.015

Cited by 334 publications

(254 citation statements)

References 37 publications

(33 reference statements)

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“…Ergonovine, hyperventilation and acetylcholine provocation can test for epicardial coronary vasospasm, which establishes the diagnosis of variant angina. Moreover, recent studies have shown that, intracoronary acetylcholine can also detect coronary endothelial dysfunction, which appears to identify patients with chest pain and normal coronary angiograms in patients without epicardial coronary artery spasm (24). In contrary to our study it is generally accepted that, CSX affects women (25).…”

Section: Discussioncontrasting

confidence: 86%

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Aykan¹,

Gökdeniz²,

Gül³

et al. 2013

Anadolu Kardiyol Derg

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Objective: Arterial stiffness is associated with major adverse cardiovascular events. Cardio-ankle vascular index (CAVI), a novel marker of arterial stiffness, which is weakly influenced by systolic blood pressure, is a sensitive marker the atherosclerosis and arteriolosclerosis. The aim of this study is to investigate arterial stiffness by CAVI in patients with cardiac syndrome X (CSX). Methods: The present study was observational and cross sectional, and involved 49 patients (26 male) with CSX (angina-like chest pain, positive electrocardiographic ischemic changes at treadmill exercise test, angiographically normal coronary arteries) and 54 healthy subjects (21 male). CAVI was measured by VaSera-1000 CAVI instrument. Statistical analysis was performed using the Chi-square, Student t-test, correlation analysis and logistic regression analysis. Results: The CAVI and pulse pressure were significantly increased in patients with CSX compared to control group (7.50±1.50, 6.49±0.77, p<0.001; 53.00±10.06, 47.39±8.17, p=0.002, consecutively). In contrast, there were no significant differences in the age, weight, height, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, mean blood pressure, glucose, low density lipoprotein level, high density lipoprotein level (HDL), triglyceride, estimated creatinine clearance, hemoglobin, left atrium diameter, left ventricular mass (LVM), LVM index and ejection fraction. CAVI was the only independent predictor of CSX in logistic regression analysis (OR=1.780, 95% CI: 1.157-2.737, p=0.009). Conclusion: CAVI is increased in syndrome X patients and is an independent predictor of this syndrome. (Anadolu Kardiyol Derg 2013; 13: 766-71) Key words: CAVI, arterial stiffness, cardiac syndrome X, coronary, angiography, regression analysis Original Investigation Özgün Araşt›rma 766ÖZET Amaç: Damar sertliği önemli kardiyovasküler kötü hadiselerle ilişkilidir. Kalp-ayak bileği vasküler indeks ölçümü (KAVI), sistolik kan basıncından çok az etkilenir ve damar sertliği değerlendirilmesinde yeni ve hassas bir yöntem olup ateroskleroz ve arteriolosklerozun hassas bir gösterge-sidir. Bu çalışmanın amacı kardiyak sendrom-X'li hastalarda (KSX) KAVI yöntemi ile damar sertliğinin değerlendirilmesidir. Yöntemler: Çalışmamız gözlemsel ve kesitsel nitelikte olup, bu çalışmada 49 KSX (tipik göğüs ağrısı olan, egzersiz elektrokardiyografi testinde pozitif iskemik değişiklikleri bulunan ve yapılan koroner anjiyografide normal koroner arterler tespit edilen hastalar) (29 erkek) ve 54 sağlıklı hasta (21 erkek) değerlendirildi. KAVI VaSera-1000 KAVI aletiyle ölçüldü. İstatistiksel analizde Ki-kare, t-testi, korelasyon analizi ve mantıksal regresyon analizi kullanıldı. Bulgular: KSX hastalarında KAVI ve nabız basıncı kontrol grubuna göre anlamlı olarak daha yüksekti

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Section: Discussioncontrasting

confidence: 86%

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Aykan¹,

Gökdeniz²,

Gül³

et al. 2013

Anadolu Kardiyol Derg

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“…Тем не менее, недавно полученные кли-нические данные свидетельствуют о том, что у двух третей пациентов, страдающих стабильной стенокар-дией, но без признаков коронарных стенозов по дан-ным ангиографии, имеются нарушения моторики коронарных артерий [19].…”

Section: ишемическая кардиомиопатияunclassified

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Montalescot

Sechtem²,

Achenbach³

et al. 2014

Russ J Cardiol

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“…14) If Caucasian cardiologists performed spasm provocation tests aggressively similar to the Japanese those, they may recognize the real truth in the clinical fields. 15) In this case, we should perform emergency CAG. However, when no significant stenosis was found, we should think that …”

Section: Discussionmentioning

confidence: 99%

A Case of Urgent PCI after Diagnosis of Acute Coronary Syndrome in a Japanese Man with Unobstructed Coronary Arteries during Posted Overseas in Southeast Asia

Sueda¹,

Sakaue²,

Kohno³

2014

J Jpn Coron Assoc

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High Prevalence of a Pathological Response to Acetylcholine Testing in Patients With Stable Angina Pectoris and Unobstructed Coronary Arteries

Cited by 334 publications

References 37 publications

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

A Case of Urgent PCI after Diagnosis of Acute Coronary Syndrome in a Japanese Man with Unobstructed Coronary Arteries during Posted Overseas in Southeast Asia

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