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Vol 26, No 6 (2019)
Original articles — Interventional cardiology
Published online: 2018-07-13
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Effect of intracoronary adenosine on ergonovine-induced vasoconstricted coronary arteries

Jun-Hyok Oh, Seunghwan Song, Changhoon Kim, Jinhee Ahn, Jin Sup Park, Hye Won Lee, Jung Hyun Choi, Han Cheol Lee, Kwang Soo Cha, Taek Jong Hong
DOI: 10.5603/CJ.a2018.0072
·
Pubmed: 30009375
·
Cardiol J 2019;26(6):653-660.

open access

Vol 26, No 6 (2019)
Original articles — Interventional cardiology
Published online: 2018-07-13

Abstract

Background: This study aimed to evaluate the effect of adenosine on epicardial coronary artery diameter
during ergonovine provocation testing.
Methods: A total of 158 patients who underwent an ergonovine provocation test with intracoronary
adenosine injection between 2011 and 2014 were selected. Patients were divided into four groups based
on the severity of percent diameter stenosis following intracoronary ergonovine administration: Group 1,
induced spasm < 50%; Group 2, 50–89%; Group 3, 90–99%; and Group 4, total occlusion.
Results: Spasm positivity was observed in 44 (27.8%) cases in the study population (mean age, 57.4 ±
± 10.7 years). Intracoronary adenosine increased the diameter of the ergonovine-induced epicardial
artery by 0.51 ± 0.31 mm, 0.73 ± 0.39 mm, 0.44 ± 0.59 mm, and 0.01 ± 0.04 mm in Groups 1, 2, 3,
and 4, respectively. Subsequent administration of nitroglycerin further increased vessel diameter by
0.49 ± 0.28 mm, 0.93 ± 0.68 mm, 2.11 ± 1.25 mm, and 2.23 ± 0.69 mm in Groups 1, 2, 3, and 4,
respectively. The ratios of adenosine-induced diameter to reference diameter were significantly lower
in patients with spasm positive results (0.68 [0.59–0.76] vs. 0.18 [0.00–0.41], p < 0.001 in the study
population; 0.60 [0.54–0.67] vs. 0.40 [0.27–0.44], p < 0.001 in Group 2) with the best cut-off value of
0.505 (sensitivity 0.955, specificity 0.921).
Conclusions: Intracoronary administration of adenosine dilated the ergonovine-induced vasoconstricted
epicardial coronary artery. The ratio of adenosine-induced diameter to reference diameter was
significantly lower in patients with spasm positive results.

Abstract

Background: This study aimed to evaluate the effect of adenosine on epicardial coronary artery diameter
during ergonovine provocation testing.
Methods: A total of 158 patients who underwent an ergonovine provocation test with intracoronary
adenosine injection between 2011 and 2014 were selected. Patients were divided into four groups based
on the severity of percent diameter stenosis following intracoronary ergonovine administration: Group 1,
induced spasm < 50%; Group 2, 50–89%; Group 3, 90–99%; and Group 4, total occlusion.
Results: Spasm positivity was observed in 44 (27.8%) cases in the study population (mean age, 57.4 ±
± 10.7 years). Intracoronary adenosine increased the diameter of the ergonovine-induced epicardial
artery by 0.51 ± 0.31 mm, 0.73 ± 0.39 mm, 0.44 ± 0.59 mm, and 0.01 ± 0.04 mm in Groups 1, 2, 3,
and 4, respectively. Subsequent administration of nitroglycerin further increased vessel diameter by
0.49 ± 0.28 mm, 0.93 ± 0.68 mm, 2.11 ± 1.25 mm, and 2.23 ± 0.69 mm in Groups 1, 2, 3, and 4,
respectively. The ratios of adenosine-induced diameter to reference diameter were significantly lower
in patients with spasm positive results (0.68 [0.59–0.76] vs. 0.18 [0.00–0.41], p < 0.001 in the study
population; 0.60 [0.54–0.67] vs. 0.40 [0.27–0.44], p < 0.001 in Group 2) with the best cut-off value of
0.505 (sensitivity 0.955, specificity 0.921).
Conclusions: Intracoronary administration of adenosine dilated the ergonovine-induced vasoconstricted
epicardial coronary artery. The ratio of adenosine-induced diameter to reference diameter was
significantly lower in patients with spasm positive results.

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Keywords

ergonovine, adenosine, vasospasm, coronary artery, angina

About this article
Title

Effect of intracoronary adenosine on ergonovine-induced vasoconstricted coronary arteries

Journal

Cardiology Journal

Issue

Vol 26, No 6 (2019)

Pages

653-660

Published online

2018-07-13

DOI

10.5603/CJ.a2018.0072

Pubmed

30009375

Bibliographic record

Cardiol J 2019;26(6):653-660.

Keywords

ergonovine
adenosine
vasospasm
coronary artery
angina

Authors

Jun-Hyok Oh
Seunghwan Song
Changhoon Kim
Jinhee Ahn
Jin Sup Park
Hye Won Lee
Jung Hyun Choi
Han Cheol Lee
Kwang Soo Cha
Taek Jong Hong

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