Abstract:
OBJECTIVES:The aim of this study was to investigate the effect of intracoronary administration of acetylcholine on large epicardial vessels 8 days after successful coronary angioplasty. BACKGROUND:Intracoronary infusion of acetylcholine causes vessel dilation in patients without angiographic evidence of coronary atherosclerosis, whereas it causes constriction of stenotic coronary branches. These findings were interpreted as evidence of endothelial dysfunction in patients with coronary atherosclerosis. METHODS:Eight patients who underwent successful single-vessel coronary angioplasty of the proximal left anterior descending artery were studied. Eight days after coronary angioplasty at the time of follow-up coronary angiography, intracoronary acetylcholine was infused (1 ml/min for 2 min) at concentrations ranging from 10(-7) to 10(-4) mol/liter. The diameter of the angioplasty and distal segments of the left anterior descending artery and that of the proximal and distal segments of the circumflex artery (control artery) were measured using computerized edge detection angiography. RESULTS:All patients showed a dose-dependent constriction in response to acetylcholine and experienced chest pain and ST segment changes. Intracoronary nitroglycerin (300 micrograms) relieved the effects of acetylcholine. The maximal tolerated dose of acetylcholine (10(-6) mol/liter in three patients, 10(-5) mol/liter in three patients and 10(-4) mol/liter in two patients) induced a mild constriction of the angioplasty segment from 1.84 +/- 0.11 mm to 1.52 +/- 0.13 mm (p < 0.02) similar to that of the proximal segment of the control artery (from 2.42 +/- 0.23 to 2.07 +/- 0.19 mm, p < 0.02). However, the degree of constriction of the vascular segments distal to the angioplasty site (from 1.24 +/- 0.09 to 0.62 +/- 0.13 mm, p < 0.01) was significantly greater (p < 0.05) than that observed in the distal segments of the control artery (from 1.23 +/- 0.03 to 0.71 +/- 0.01 mm, p < 0.01) and resulted in transient total occlusion in two patients. CONCLUSIONS:Eight days after coronary angioplasty, coronary segments distal to the dilated site but not at the dilated site are hyperreactive to acetylcholine. The response of epicardial coronary arteries to acetylcholine is influenced not only by the dose of acetylcholine and the endothelial function (as currently believed) but also by the location of the coronary segment considered, confirming the presence of a profound alteration of distal coronary vessels.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
el-Tamimi H,Davies GJ,Crea F,Maseri Adoi
10.1016/0735-1097(93)90239-wsubject
Has Abstractpub_date
1993-04-01 00:00:00pages
1152-7issue
5eissn
0735-1097issn
1558-3597pii
0735-1097(93)90239-Wjournal_volume
21pub_type
杂志文章abstract:OBJECTIVES:The purpose of this study was to determine long-term effects of stent-based paclitaxel delivery on amount, rate and composition of neointimal thickening after stent implantation. BACKGROUND:Paclitaxel prevents vascular smooth muscle cell proliferation and migration in vitro and in vivo. These actions, coupl...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(00)01020-2
更新日期:2000-12-01 00:00:00
abstract::In a 69 year old woman with a "sticking" Björk-Shiley mitral prosthesis, the diagnosis was suggested by both the two-dimensional and the Doppler ultrasound examinations. In particular, the findings of early diastolic paradoxic septal motion, intermittent delayed opening of the prosthetic disc and variable timing of th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80443-0
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Aortic stiffening and reduced nitric oxide (NO) availability may contribute to the pathophysiology of heart failure with preserved ejection fraction (HFpEF). OBJECTIVES:This study compared indices of arterial stiffness at rest and during exercise in subjects with HFpEF and hypertensive control subjects to e...
journal_title:Journal of the American College of Cardiology
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更新日期:2017-07-11 00:00:00
abstract:OBJECTIVES:We evaluated metallothionein (MT)-mediated cardioprotection from angiotensin II (Ang II)-induced pathologic remodeling with and without underlying diabetes. BACKGROUND:Cardiac-specific metallothionein-overexpressing transgenic (MT-TG) mice are resistant to diabetic cardiomyopathy largely because of the anti...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2008.05.019
更新日期:2008-08-19 00:00:00
abstract:BACKGROUND:Patients with diabetes appear to be at elevated risk of atherothrombotic events. OBJECTIVES:The purpose of this study was to determine the effect of antiplatelet therapy with ticagrelor on recurrent ischemic events in patients with diabetes and prior myocardial infarction (MI). METHODS:We examined the subg...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2016-06-14 00:00:00
abstract::The adequacy of two-dimensional echocardiography during right atrial pacing for the detection and characterization of coronary artery stenosis was examined in 10 closed chest dogs. Pacing at successively higher rates up to 210 beats/min was carried out in the control state and again during a 70% left anterior descendi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80309-x
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abstract:OBJECTIVES:The aim of this study was to investigate the frequency of viral nucleic acid detection in the myocardium of human immunodeficiency virus (HIV)-infected children to determine whether an association exists with the development of heart disease. BACKGROUND:As improved medical interventions increase the life ex...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(99)00264-8
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:The aim of this research was to describe N-terminal part of the pro-B-type natriuretic peptide (NT-proBNP) levels over time in non-ST-segment elevation acute coronary syndromes (NSTEACS), to elucidate factors associated with changes of NT-proBNP levels, and to examine association with long-term mortality. B...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2005-02-15 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1997-06-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1995-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2006-06-06 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2002-06-19 00:00:00
abstract::The utility of ergonovine testing for coronary artery spasm was assessed in 3,447 patients with angiographically insignificant (less than 50% diameter stenosis) or no coronary artery disease. No patients clinically had Prinzmetal's variant angina. Overall, 4% had a positive ergonovine test result, defined by spasm cau...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90145-d
更新日期:1992-07-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0735-1097(92)90242-f
更新日期:1992-11-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1986-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2018.06.048
更新日期:2018-08-21 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(00)00819-6
更新日期:2000-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-05-01 00:00:00
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更新日期:2001-09-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1990-12-01 00:00:00
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更新日期:2007-10-23 00:00:00
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更新日期:2011-10-11 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80298-x
更新日期:1987-05-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2014-10-21 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1984-06-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1995-04-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2014.01.046
更新日期:2014-05-20 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90279-v
更新日期:1992-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2008-05-06 00:00:00