Intracoronary Ultrasound in Patients with Coronary Vasospasm or Vasoconstriction.
10.4070/kcj.1997.27.3.296
- Author:
Hyeon Cheol GWON
;
Jae Choon RYU
;
Byung Ryul JO
;
Myeong Gon KIM
;
Seung Woo PARK
;
Joon Soo KIM
;
Duk Kyung KIM
;
Sang Hoon LEE
;
Kyung Pyo HONG
;
Jung Euy PARK
;
Won Ro LEE
- Publication Type:Original Article
- Keywords:
Coronaty vasospasm;
Acetylcholine;
Intravascular ultrasound;
Atherosclerosis
- MeSH:
Acetylcholine;
Atherosclerosis;
Constriction;
Coronary Vasospasm*;
Humans;
Plaque, Atherosclerotic;
Spasm;
Ultrasonography*;
Ultrasonography, Interventional;
Vasoconstriction*
- From:Korean Circulation Journal
1997;27(3):296-302
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: It has been hypothesized that early atherosclerosis may be related to the pathogenesis of coronary vasospasm. This study was designed to investigate the relationship between early atherosclersosis and coronary vasospasm or vasoconstriction in response to axetylcholine utilizing intravascular ultrasonography. METHOD: Total 43 segments were analyzed from subjects who were composed of 10 patients with and 7 patients without coronary vasospasm in response to intra coronary acetylcholine infusion. Spasm segment(Sp) was defined as total or subtotal occlusion, constriction segment(C) as diameter decrease>/=10%, and normal segment(N) as diameter decrease<10% compared to baseline coronary angiogram. Atherosclerotic plaque thickness was defined as the sum of thickness of intimal leading edge and sonolucent zone. Atherosclerosis was defined as atherosclerotic plaque thickness > 0.5mm. RESULTS: The atherosclerotic plaques of spasm segments were significantly thicker than those of normal and constriction segments(spasm segments : 1.19+/-0.21mm, constrict segments : 0.58+/-0.11mm, normal segment : 0.37+/-0.11, p<0.05). Atherosclerosis was present in 90% of spasm segments. Among normal of constriction segments, atherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm, although it was statistically insignificant(patients with vasospasm : 0.65+/-0.51mm, patients without vasospasm 0.36+/-0.39mm, p=0.07). Frequency of atherosclerosis in normal or constriction segments was significantly higher in patients with vasospasm than patients without vasospasm(patients with vasospasm 47%, patients without vasospasm : 11%, p<0.05). CONCLUSION: Atherosclerosis is present at segments of vasospasm in response to intracoronary acetylcholine. Even among normal or constriction segments, the artherosclerotic plaque thickness of patients with vasospasm was thicker than that of patients without vasospasm which may indicates that coronary vasospasm is a diffuse early atherosclerotic disease.
