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December 1, 1991CirculationOpen Access

Inappropriate constriction of small coronary vessels as a possible cause of a positive exercise test early after successful coronary angioplasty.

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Why the study?

Does inappropriate small coronary vessel constriction cause exercise-induced myocardial ischemia early after successful PTCA?

Population

12 patients who underwent one-vessel percutaneous transluminal coronary angioplasty and had a positive…

Comparison

Exercise testing on day 7 after PTCA, and… vs Patients with a positive exercise test on day 7…

Design

Cohort

Follow-up

8 days

Authors

HEHassan El‐TamimiGDGraham J. DaviesPSPiyamitr Sritara

Discussion

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Overview

Similar ergonovine constriction regardless of exercise-test result post-PTCA; leaves open mechanisms of early ischemia beyond small-vessel spasm.

Structured PICO

Does inappropriate small coronary vessel constriction cause exercise-induced myocardial ischemia early after successful PTCA?

P
Population
12 patients who underwent one-vessel percutaneous transluminal coronary angioplasty (PTCA) and had a positive exercise test before PTCA.
I
Intervention
Exercise testing on day 7 after PTCA (repeated after 10 mg sublingual isosorbide dinitrate if positive), and quantitative coronary arteriography on day 8 with intracoronary infusion of 0.9% saline, 1, 5, 10, and 20 micrograms ergonovine, and 300 micrograms nitroglycerin.
C
Comparator
Patients with a positive exercise test on day 7 (group 1, n=6) compared to those with a negative exercise test on day 7 (group 2, n=6).
O
Outcome
Magnitude of coronary segment constriction in response to intracoronary ergonovine.surrogate

Exercise-induced myocardial ischemia early after successful PTCA may be caused by inappropriate small coronary vessel constriction responsive to nitrates, rather than epicardial spasm or restenosis.

Cite This Study

El‐Tamimi et al. (1991) studied this question.

synapsesocial.com/papers/6a89699dabb0ef83c5c98022https://doi.org/10.1161/01.cir.84.6.2307
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Coronary artery vasoconstriction routinely occurs after percutaneous transluminal coronary angioplasty. A quantitative arteriographic analysis.1988 · 211 citations
  2. 2Vasoconstriction of stenotic coronary arteries during dynamic exercise in patients with classic angina pectoris: reversibility by nitroglycerin.1986 · 373 citations
  3. 3Coronary stenosis vasomotion during dynamic exercise before and after PTCA1989 · 19 citations
  4. 4Abnormal vasomotor changes early after coronary angioplasty. A quantitative arteriographic study of their time course.1991 · 56 citations
  5. 5The inducibility of coronary artery spasm after successful PTCA1988 · 1 citations