Effects of anti-vasospastic agents in Japanese patients with dilated cardiomyopathy and coronary vasospasm.
نویسندگان
چکیده
The pathogenesis of dilated cardiomyopathy (DCM) is unknown, but clinical evidence suggests that coronary vasospasm is associated with the development of DCM in some cases. In the present study, we aimed to clarify the prevalence of coronary vasospasm in patients with DCM, the characteristics of patients with DCM and coronary vasospasm, and the effects of anti-vasospastic agents on patients with DCM and coronary vasospasm. This study included 18 consecutive patients with DCM who underwent cardiac catheterization with ergonovine provocation testing. The patient was diagnosed as having coronary vasospasm if ergonovine induced coronary vasoconstriction > or = 75% diameter narrowing was observed compared to the diameter after nitroglycerin administration. Six (33%) patients were found to have coronary vasospasm and anti-vasospastic agents were added after the cardiac catheterization. The prevalence of atrial fibrillation in the patients with DCM and coronary vasospasm was greater than that in DCM without coronary vasospasm [67% vs 8% (P<0.05)]. The left ventricular end-diastolic dimension decreased from 61 mm (56/64) to 55 mm (53/56) (median, 25th/75th percentile, P<0.05) and the left ventricular ejection fraction increased from 36% (32/40) to 47% (46/48) (median, 25th/ 75th percentile, P<0.05) after the administration of anti-vasospastic agents and 4 of the 6 patients improved symptomatically. Therefore, ergonovine provocation testing is useful in identifying patients with DCM and coronary vasospasm, in whom cardiac performance is expected to be improved with anti-vasospastic agent therapy. DCM patients with atrial fibrillation may be a clue for identifying patients with coronary vasospasm.
منابع مشابه
The value of myocardial perfusion imaging in differentiating between idiopathic dilated cardiomyopathy from the ischemic form [Persian]
Introduction: Differentiating between ischemic cardiomyopathy (ICM) and idiopathic dilated cardiomyopathy (IDCM) is important as coronary revascularization can improve prognosis in the ischemic subgroup. Due to inherent problems of coronary angiography in patients with depressed ejection fraction (EF) introducing a noninvasive tool to diagnose those who will benefit from angiography seems...
متن کاملCryptogenic hemoptysis and smoking.
1 Kodama K, Hamada M, Kazatani Y, et al. Clinical characteristics in Japanese patients with coexistent hypertrophic cardiomyopathy and coronary vasospasm. Angiology 1998; 49: 849–855 2 Kodama K, Shigematsu Y, Hamada M, et al. The effect of coronary vasospasm on the direction of ST-segment deviation in patients with both hypertrophic cardiomyopathy and vasospastic angina. Chest 2000; 117:1300–13...
متن کاملGuidelines for diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) (JCS 2008): digest version.
متن کامل
Severe multivessel coronary vasospasm and left ventricular ballooning syndrome.
In their first description of Takotsubo cardiomyopathy (TC), Dote et al1 hypothesized that the disease was caused by multivessel coronary vasospasm, because 4 of 5 patients in their report had either spontaneous or provocable coronary vasospasm on coronary angiography. However, later studies did not find supporting evidence for the pathogenic role of coronary vasospasm. Recently, the vasospasm ...
متن کاملDirect myocardial and coronary effects of enalaprilat in patients with dilated cardiomyopathy: assessment by a bilateral intracoronary infusion technique.
Angiotensin II elicits contractile responses in the coronary arteries and myocardial tissue, which suggests that blockade of the renin-angiotensin system by specific agents should lead to both coronary vasodilation and an alteration of left ventricular inotropism. The present work was designed to delineate--independently from its systemic effects--the intrinsic actions of an angiotensin convert...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Japanese heart journal
دوره 43 4 شماره
صفحات -
تاریخ انتشار 2002