Intravascular Ultrasound Findings of Arterial Remodeling at the Sites of Focal Coronary Spasm in Patients with Vasospatic Angina

Background:There is little data about concerning the intravascular ultrasound (IVUS) findings in the patients with vasospastic angina, especially particularly with respect to patterns of vascular remodeling. Methods: Coronary spasm was documented by angiography and ECG evidence of ischemia in 36 patients after following the administration of ergonovine (cumulative doses up to 350 μg). After relief of spasm using 1,000 μg of intracoronary nitroglycerin, IVUS imaging was performed and analyzed using standard methodology. The 36 focal spasm sites were compared to the proximal and distal reference segments. Results:The angiographic baseline minimum lumen diameter measured 1.78±0.66 mm, which decreased to 0.66±0.38 mm with ergonovine provocaton (p proximal reference) was present in 5 patients;intermediate remodeling (proximal reference>spasm site>distal reference arterial area) was present in 7;and negative remodeling (spasm site arterial area<distal reference) was present in 24. Conclusions:Sites of focal vasospasm in patients with vasospastic angina showed characteristics of early atherosclerosis except for an unusually high incidence of negative arterial remodeling. (Korean Circulation J 2001;31(2):182-190)