Incremental atrial pacing in patients with angina and normal coronary arteries resulted in a significantly smaller fall in coronary sinus pH compared to CAD patients (-0.02 vs -0.11 pH units; P<0.01).
Observational (n=23)
Does incremental atrial pacing induce metabolic evidence of myocardial ischemia in patients with angina and normal coronary arteries compared to patients with coronary artery disease?
Despite experiencing severe chest pain and having reduced coronary flow reserve, most patients with angina and normal coronary arteriograms do not exhibit metabolic evidence of myocardial ischemia during atrial pacing.
Tasa de eventos absoluta: -0.02% vs -0.11%
valor p: p=< 0.01
BACKGROUND: Whether myocardial ischaemia is the mechanism underlying chest pain in patients with angina and normal coronary arteriograms is controversial. We sought to detect the presence of transient myocardial ischaemia using continuous monitoring of coronary sinus blood pH during atrial pacing. METHODS AND RESULTS: We studied 14 patients (eight women, six men, mean age 51 +/- 3 years) with typical exertional angina and normal coronary arteriograms and nine patients with coronary artery disease (two men, seven women, mean age 61 +/- 7 years). Of the 14 patients with normal coronary arteries, eight had a reduced coronary blood flow reserve ( 0.02 pH units (-0.043 +/- 0.006 pH units) and in coronary sinus oxygen saturation > 8% (16 +/- 3%) consistent with myocardial ischaemia. CONCLUSION: Despite severe chest pain and reduced coronary flow reserve after pacing, most patients with angina and normal coronary arteriograms do not show metabolic evidence of myocardial ischaemia.
Rosano et al. (Fri,) conducted a observational in Angina with normal coronary arteries (n=23). Incremental atrial pacing vs. Patients with coronary artery disease was evaluated on Fall in coronary sinus pH (p=< 0.01). Incremental atrial pacing in patients with angina and normal coronary arteries resulted in a significantly smaller fall in coronary sinus pH compared to CAD patients (-0.02 vs -0.11 pH units; P<0.01).