We read with great interest the paper by Sicari et al. dealing with the prognostic value of dipyridamole echocardiography test in patients with chest pain syndrome and angiographically normal or near normal coronary arteries and the accompanying editorial by Marwick. This study, based in a large cohort with long-term follow-up, shows that dipyridamole echocardiography can identify a subgroup wi...

3 Silverman ME, Flamm MD: Variant angina pectoris-Anatomic &ding and pmgno8tic implications. Ann Intern Med 75:339,1971 4 Prinzmetal M, K m e r R, Merliss R, et al: Angina pedwis I. Variant form of angina pectoris. Am J Med 27:375, 1959 5 Hart NJ, Silverman ME, King SB: Variant angina pedwis caused by coronary artery spasm. Am J Med 356:e69, 1974 6 Oliva PB, Potts DE, Pluss RC: Coronary arteria...

Coronary artery vasospasm following administration of sublingual (SL) nitroglycerin (NTG) was first described in the literature by Feldman and colleagues in 1978 [1]. The frequency of this finding and its clinical significance is unknown; however, it is corroborated by other reports of paradoxical blood pressure elevation after nitroglycerin administration [2] and anecdotally noted rare patient...

OBJECTIVE Phospholipase C-δ1 activity is enhanced in patients with coronary artery spasm, and a p122 protein was recently cloned to potentiate phospholipase C-δ1 activity. To investigate the role of p122 in enhanced vasomotility, we examined p122 expression in the cultured skin fibroblasts obtained from patients with and without coronary spasm, intracellular Ca(2+) concentration ([Ca(2+)]i) [co...

We report a 67-year-old Japanese man who presented with worsening heart failure with asymptomatically transient ischemic ST-segment depression. Left ventriculography showed diffuse hypokinesis; asymptomatic coronary artery spasm was evoked by the acetylcholine provocation test. Endomyocardial biopsy exhibited hypertrophic cardiomyocytes and scattered microscopic focal myocardial necrosis with a...

Coronary artery spasm is a recognized cause of myocardial infarction. This report describes a case of myocardial infarction attributed to pure coronary spasm which was halted by a double perfusion with streptokinase and nitroglycerin. Further coronary artery spasm leading to a myocardial infarction could not be avoided several weeks later, although the patient was left on calcium channel blocke...

In a patient with variant angina, we have shown that the calcium-channel blocker nifedipine inhibits both spontaneous and ergonivine-induced coronary artery spasm. It had no effect, however, on the dose-related diffuse vasoconstriction caused by ergonovine, suggesting two distinct responses of coronary arteries to ergonovine provocation. Nifedipine did not cause epicardial coronary artery dilat...

Objective—Phospholipase C1 activity is enhanced in patients with coronary artery spasm, and a p122 protein was recently cloned to potentiate phospholipase C1 activity. To investigate the role of p122 in enhanced vasomotility, we examined p122 expression in the cultured skin fibroblasts obtained from patients with and without coronary spasm, intracellular Ca concentration ([Ca ]i) at baseline an...

Effects of leukotriene (LT) C4 and LTD4 on coronary artery spasm in atherosclerotic miniature pigs were examined angiographically. Endothelial balloon denudation of the left circumflex coronary artery was performed in 15 Göttingen miniature pigs; 11 were fed a 2% cholesterol diet and four were fed a regular diet for 3 months. Three months after this denudation, the area of the coronary artery w...

BACKGROUND Enhanced coronary vasomotion may contribute to acute coronary occlusion during the acute phase of myocardial infarction (AMI). Japanese have a higher incidence of variant angina than Caucasian patients, but racial differences in vasomotor reactivity early after AMI are controversial. METHODS AND RESULTS The same team studied 15 Japanese and 19 Caucasian patients within 14 days of A...