Effects of L-Arginine on Coronary Artery Spasm Induced by Intracoronary Acetylcholine in Patients with Angina Pectoris with Normal Coronary Angiogram.
10.4070/kcj.1998.28.2.230
- Author:
Chang Gyu PARK
;
Dong Joo OH
;
Hong Seog SEO
;
Eun Mi LEE
;
Jung Chun AHN
;
Woo Hyuk SONG
;
Do Sun LIM
;
Young Hoon KIM
;
Wan Joo SHIM
;
Young Moo RO
- Publication Type:Original Article
- Keywords:
L-arginine;
Spasm;
Nitric oxide
- MeSH:
Acetylcholine*;
Angina Pectoris*;
Arginine*;
Blood Pressure;
Coronary Vessels*;
Endothelium;
Heart Rate;
Humans;
Muscle Spasticity;
Nitric Oxide;
Spasm*;
Vasodilation
- From:Korean Circulation Journal
1998;28(2):230-236
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Coronary spasm can be induced by acetylcholine (ACh) ACh casues vasodilation when the endothelium is intact by releasing nitric oxide (NO). The aim of this study was to investigate whether L-arginine, the precursor of NO, could preserve endothelium-dependent vasodilation in patients with coronary artery spasm. METHOD: NO precusor L-arginine (20mg/kg/min) was infused intravenous for 30 minutes in nineteen patients with coronary spastic angina. Coronary spasm of the epicardial coronary artery (>75%) was induced by intracoronary injection of acetylcholine in incremental doses (ACh: A1 20ug, A2 50ug, A3 100ug) the spasm was then documented angiographically in all patients with coronary spastic angina. After the administration of L-arginine, intracoronary injection of acetylcholine was repeated as the same method in all coronary spastic angina patients. RESULTS: After systemic infusion of L-arginine, the constrictor response to ACh was significanfly attenuated : no spastic response in 8 cases (42%), increased doses of ACh for provoking spasm in 8 cases (42%) and no change in 3 cases (16%). There were no significant change in blood pressure and heart rate after the administration of L-arginine. CONCLUSION: The fact that L-arginine attenuated vasospasm provoked by ACh in human coronary arteries, suggests the possibilities that L-arginine may be used in the prevention and treatment of coronary spasm.
