Angiographic and Clinical Characteristics according to Intracoronary Acetylcholine Dose in Patients with Myocardial Bridge

作者：Im Sung Il; Rha Seung Woon^*; Choi Byoung Geol; Choi Se Yeon; Kim Sun Won; Na Jin Oh; Choi Cheol Ung; Lim Hong Euy; Kim Jin Won; Kim Eung Ju; Park Chang Gyu; Seo Hong Seog; Oh Dong Joo

来源：Cardiology, 2013, 125(4): 250-257.

DOI：10.1159/000351181

• Vasospastic angina
• Acetylcholine dose
• Myocardial bridge

Objectives: It is well known that myocardial bridge (MB) is a risk factor of vasospastic angina. However, clinical and angiographic characteristics according to different acetylcholine (ACh) dose in patients with MB are not clarified yet. Methods: A total 483 consecutive patients who had angiographically proven MB underwent the intracoronary ACh provocation test. ACh was injected by incremental doses of 20, 50 and 100 mu g into the left coronary artery. We evaluated the clinical and angiographic characteristics of patients with MB according to 3 different ACh doses. Results: The baseline clinical and procedural characteristics are well balanced among the three groups. The MB patients who responded to the lower ACh dose (20 mu g) had higher incidence of baseline spasm, severe vasospasm and diffuse long spasms (%26gt;30 mm) than those who responded to the higher doses (50 and 100 mu g). The incidence of 12-month mortality and recurrent chest pain was higher in the lower ACh dose group (20 mu g). Conclusion: The patients with MB significantly reacting at the low ACh dose had more pronounced baseline spasm, severe and diffuse long coronary artery spasm, higher 12-month mortality and recurrent chest pain than those reacting with the higher ACh doses, suggesting that more intensive medical therapy will be required.

• 出版日期2013