Prinzmetal's variant form of angina with arteriographic evidence of coronary arterial spasm

Dhurandhar, Raja W.; Watt, David L.; Silver, Malcolm D.; Trimble, Alan S.; Adelman, Allan G.

doi:10.1016/0002-9149(72)90018-5

Cited by 222 publications

(28 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Taken together this with the effectiveness of the directlyacting calcium entry blockers, an increased calcium influx plays a key role in the spontaneous rhythmic contractions of isolated subhuman primate coronary arteries and also of isolated human coronary arteries. However, the ineffectiveness of nitroglycerin on these spontaneous rhythmic contractions casts a doubt on the concept that they have something to do with coronary artery spasm, because nitroglycerin is highly efficacious in releasing coronary artery spasm associated with vasospastic angina (Dhurandhar et al 1972;Oliva et al 1973).…”

Section: Discussionmentioning

confidence: 99%

Abolition of spontaneous rhythmic contractions of isolated monkey coronary arteries by diltiazem, nifedipine, verapamil and nicorandil but not by nitroglycerin.

Ishii

Yanagisawa

Satoh

et al. 1985

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Abolition of spontaneous rhythmic contractions of isolated monkey coronary arteries by diltiazem, nifedipine, verapamil and nicorandil but not by nitroglycerin.

Ishii

Yanagisawa

Satoh

et al. 1985

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

“…However, recently the importance of reperfusion arrhythmias has begun to emerge. With the concept of co~onary artery spasm firmly established (21,22), the functional components necessary to produce temporary myocardial ischemia and reperfusion are readilv available in the clinical setting.…”

mentioning

confidence: 99%

Electrophysiology of coronary reperfusion. A mechanism for reperfusion arrhythmias.

Murdock¹,

Loeb²,

Euler³

et al. 1980

Circulation

110

View full text Add to dashboard Cite

“…The ECG lead showing the most obvious changes during the ischemic episodes was continuously monitored on the CCU central station and simultaneously analyzed in real time by a computer program with beat-by-beat display of heart rate and ST-T positive and negative areas.39""' The data were also simultaneously recorded on an analog magnetic tape. Arterial pressure (cuff) was measured every 5 minutes in the first 30 minutes of each infusion period and then every 30 minutes. Citrated blood samples In the three patients in whom a transient ischemic episode with ST-segment elevation could be induced by i.v.…”

Section: Pgi2 Infusion In Spontaneous Anginamentioning

confidence: 99%

Effects of intravenous prostacyclin in variant angina.

Chierchia¹,

Patrono²,

Crea³

et al. 1982

Circulation

104

View full text Add to dashboard Cite

SUMMARY A lack in prostacyclin (PGI2) production due to atherosclerosis may play a role in the pathophysiology of some of the clinical manifestations of ischemic heart disease and, in particular, of coronary vasospasm. We therefore evaluated the effects of i.v. PGI, in nine patients with variant angina and six normal volunteers.In normal subjects, PGI2 (2.5, 5, 10 and 20 jg/kg/min) had significant antiplatelet effects, caused a dosedependent decrease in both systolic and diastolic arterial pressure and a decrease in pulmonary resistance. Heart rate increased in a dose-dependent manner, but no consistent effects on myocardial contractility (evaluated by ultrasound) were observed. Side effects were negligible and readily reversible.Although producing obvious antiplatelet and vasodilatory effects, PGI2 did not affect the number, severity and duration of spontaneous ischemic episodes due to coronary vasospasm in five patients and ergonovineinduced spasm in three. However, the number of ischemic episodes was consistently reduced in one patient during four consecutive periods of PGI2 infusion alternated with placebo. A severe, prolonged ischemic episode with ST elevation and pain was consistently observed in this patient every time PGI2 was discontinued.In the appropriate environment, PGI2 can be administered safely to patients with ischemic heart disease. Occasionally, PGI2 may result in a complete disappearance of ischemic episodes due to coronary vasospasm, but usually it is ineffective. These conflicting results could be related to different etiologies of coronary spasm. PROSTACYCLIN (PGI2), an arachidonic acid metabolite produced by the vascular endothelial cells and by the lungs,'-3 exerts powerful vasodilating and antiplatelet effects in vitro4-8 and in vivo.9-' These effects may avoid intravascular thrombosis, maintain endothelial integrity and, possibly, control vascular smooth muscle tone. Decreased PGI2 production by the atherosclerotic arterial wall might play a role in some of the clinical manifestations of ischemic heart disease.'3 20 Maseri et al.2' suggested that coronary vasospasm could result from an increased vascular sensitivity to vasoconstrictor stimuli, secondary to a reduction in local PGI2 production at the site of atherosclerotic lesions. Moreover, the hypothesis that transient coronary vasospasm might be precipitated by thromboxane A2, locally released by aggregating platelets,22 in the presence of endothelial lesions has SubjectsFive healthy male subjects, all coauthors of the present report (SC, GC, GAC, AM and CP), ages from 32-50 years (mean age 38 years) volunteered for the study. One male patient (NV), age 34 years, submitted to routine coronary angiography and coronary sinus catheterization because of atypical precordial pain. He gave informed consent to the infusion of the drug after the completion of the diagnostic study, which had failed to demonstrate coronary lesions or hemodynamic or myocardial metabolic abnormality. PGI2 Preparation and Mode of AdministrationThe sodium salt o...

show abstract

Prinzmetal's variant form of angina with arteriographic evidence of coronary arterial spasm

Cited by 222 publications

References 6 publications

Abolition of spontaneous rhythmic contractions of isolated monkey coronary arteries by diltiazem, nifedipine, verapamil and nicorandil but not by nitroglycerin.

Abolition of spontaneous rhythmic contractions of isolated monkey coronary arteries by diltiazem, nifedipine, verapamil and nicorandil but not by nitroglycerin.

Electrophysiology of coronary reperfusion. A mechanism for reperfusion arrhythmias.

Effects of intravenous prostacyclin in variant angina.

Contact Info

Product

Resources

About