This study was done to evaluate changes of microvascular function under cold stimulation by measuring coronary flow velocities (CFVs) in vasospastic angina (VA) patients using transthoracic Doppler echocardiography (TTDE). 14 patients with VA and 15 healthy controls were included. CFVs were measured at the distal left anterior descending coronary artery by TTDE at baseline and under cold stimulation. Hyperemia was induced by intravenous adenosine infusion (140 microgram/kg/min). At baseline, CFVs and coronary flow reserve (CFR) were not different between controls and VA patients. Under cold stimulation, the degree of increment of CFV with adenosine was lower in VA patients than in controls. Comparing baseline with cold stimulation, coronary flow reserve (CFR) increased (3.1 +/-0.7 to 3.8 +/-1.0, p=0.06) in controls. In contrast, in VA patients, CFR was decreased (2.8 +/-0.9 to 2.6 +/-0.7, p=0.05) and coronary vascular resistance index markedly increased (0.35 to 0.43, p=0.01). Throughout the study, no patient experienced chest pain or ECG changes. In VA patients, CFR was preserved at baseline, but coronary blood flow increase in response to cold stimulation was blunted and CFR was decreased. These findings suggest that endothelial dependent vasodilation is impaired at the coronary microvascular and the epicardial artery level in VA under cold stimulation.
Adult ; Aged ; Angina Pectoris/*physiopathology/ultrasonography ; Cold ; *Coronary Circulation ; *Echocardiography, Doppler ; Female ; Humans ; Male ; Microcirculation/physiopathology ; Middle Aged

OBJECTIVETo evaluate the efficacy and safety of Ginkgo Biloba extract for patients with angina pectoris according to the available evidence.

METHODSElectronic databases were searched for all of the randomized controlled trials (RCTs) of angina pectoris treatments with Ginkgo Biloba extract, either alone or combined with routine Western medicine (RWM), and controlled by untreated, placebo, Chinese patent medicine, or RWM treatment. The RCTs were retrieved from the following electronic databases: PubMed/MEDLINE, ProQuest Health and Medical Complete, Springer, Elsevier, and ProQuest Dissertations and Theses, Wanfang Data, China National Knowledge Infrastructure (CNKI), VIP database, China Biology Medicine (CBM), Chinese Medical Citation Index (CMCI), from the earliest database records to December 2012. No language restriction was applied. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. RevMan 5.1.0 provided by Cochrane Collaboration The data were analysed by using.

RESULTSA total of 23 RCTs (involving 2,529 patients) were included and the methodological quality was evaluated as generally low. Ginkgo Biloba extract with RWM was more effective in angina relief and electrocardiogram improvement than RWM alone. Reported adverse events included epigastric discomfort, nausea, gastrointestinal reaction, and bitter taste.

CONCLUSIONSGinkgo Biloba extract may have beneficial effects on patients with angina pectoris, although the low quality of existing trials makes it difficult to draw a satisfactory conclusion. More rigorous, high quality clinical trials are needed to provide conclusive evidence.

Angina Pectoris ; diagnostic imaging ; drug therapy ; physiopathology ; Cardiac Output ; Clinical Trials as Topic ; Ginkgo biloba ; chemistry ; Humans ; Plant Extracts ; adverse effects ; therapeutic use ; Stroke Volume ; drug effects ; Ultrasonography

OBJECTIVETo explore the anti-atherosclerosis effect of Taizhi'an Capsule (TZA) for providing a theoretical base of its application in preventing coronary heart disease (CHD), by way of observing the effects of TZA and pravastatin (PVT) on vascular endothelial function in senile patients with CHD.

METHODSSeventy-eight Senile patients with CHD were randomly divided into the TZA group and the PVT group, 39 in each group. Changes of carotid arterial intima-media thickness (IMT) and brachial arterial endothelium dependent diastolic function (FMD) before and after treatment were observed by non-invasive ultrasound test technique, and levels of serum nitric oxide (NO) and plasma endothelin-1 (ET-1) were determined as well.

RESULTSAfter TAZ treatment, IMT decreased from 1.21 +/- 0.17 mm to 0.91 +/- 0.13 mm, FMD increased from 5.02 +/- 0.58% to 8.97 +/- 0.39%, ET-1 lowered from 95.93 +/- 19.41 ng/L to 49.35 +/- 53.27 ng/L, and NO enhanced from 42.56 +/- 14.12 mumol/L to 69.84 +/- 21.96 mumol/L; after PVT treatment, the corresponding changes were 1.25 +/- 0.21 mm to 0.88 +/- 0.32 mm, 4.90 +/- 0.37% to 8.12 +/- 0.25%, 89.35 +/- 10.02 ng/L to 47.96 +/- 11.05 ng/L and 51.71 +/- 9.39 mumol/L to 72.93 +/- 16.51 mumol/L, all the changes were statistically significant.

CONCLUSIONTZA can obviously improve the vascular endothelial function in old patients with CHD, which has the anti-atherosclerosis effect similar to that of PVT.

Aged ; Angina Pectoris ; diagnostic imaging ; drug therapy ; physiopathology ; Carotid Arteries ; diagnostic imaging ; pathology ; physiopathology ; Coronary Disease ; diagnostic imaging ; drug therapy ; physiopathology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Phytotherapy ; Pravastatin ; therapeutic use ; Ultrasonography