Erschienen in:
06.11.2015 | Original Article
Left ventricular end diastolic pressure for detection of intracoronary ergonovine-induced myocardial ischemia
verfasst von:
H.-J. Jang, T.-H. Kim, MD, PhD, S.W. Kwon, J.-Y. Kim, J.S. Kim, H.J. Lee, J.S. Park, R.K. Choi, Y.J. Choi, W.-H. Shim
Erschienen in:
Herz
|
Ausgabe 4/2016
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Abstract
Background
Recent consensus on variant angina defines significant spasm as total or subtotal occlusion of a coronary artery. However, the clinical significance of “less-than-subtotal” spasm needs to be reappraised, especially if the coronary spasm is combined with chest pain. Therefore, we evaluated the feasibility of left ventricular end diastolic pressure (LVEDP) as a tool to detect myocardial ischemia during ergonovine provocation testing.
Methods
After achieving two access sites, 29 patients underwent successful LVEDP monitoring using 5-Fr pigtail catheters during ergonovine provocation tests. Patients were divided into two groups based on the occurrence of anginal symptoms.
Results
Of the 29 patients, 16 (55 %) patients had anginal symptoms. LVEDP was significantly increased in the symptomatic group compared with the nonsymptomatic group (∆LVEDP 5.6 ± 4.2 vs. 1.2 ± 2.0 mmHg, p = 0.002). However, of the 16 patients with anginal symptoms, positive provocation test results were confirmed in only six patients (38 %) as per the traditional standard (> 90 % inducible spasm of the epicardial coronary artery).
Conclusion
Compared with the traditional standard, LVEDP may have advantages in terms of elucidating anginal symptoms in patients suspected of having coronary vasospasm when performing ergonovine provocation tests.