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KMID : 0978920100110040324
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Korean Journal of Clinical Geriatrics
2010 Volume.11 No. 4 p.324 ~ p.331
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Impact of Ischemic ECG Change and Chest Pain on Acetylcholine-Induced Endothelial Dysfunction during Acetylcholine Provocation Tests
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Choi Cheol-Ung
Rha Seung-Woon
Kim Sun-Won
Na Jin-Oh
Lim Hong-Euy
Kim Jin-Won
Kim Eung-Ju
Han Seong-Woo
Park Chang-Gyu
Seo Hong-Seog
Oh Dong-Joo
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Abstract
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Background: ECG changes and chest pain during acetylcholine (Ach) provocation tests may constitute important clinical parameters for Ach-induced endothelial dysfunction. We investigated the association between ischemic ECG changes and chest pain during the Ach-provocation test and angiographic characteristics of Ach-induced endothelial dysfunction.
Methods: A total of 1,085 patients with anginal symptoms underwent diagnostic coronary angiography (CAG) and Ach-provocation tests. We compared angiographic characteristics of Ach-induced endothelial dysfunction according to the presence of ECG change and chest pain.
Results: A total of 539 patients experienced Ach-induced endothelial dysfunction. Patients who experienced ECG change group suffered more frequent chest pain (78.1% vs. 60.8%, P=0.007),angiographically more frequent multiple coronary artery spasm (59.4% vs. 40.6%, P=0.004), and more severe coronary artery spasm (64.1% vs. 46.5%, P=0.006) than patients without ECG change. However, there was no difference in the length of endothelial dysfunction between the groups. The incidence of ischemic ECG changes in patients with chest pain was higher than in patients without chest pain (14.7% vs. 7.5%, P=0.007). Patients who experienced chest pain more often experienced multiple (50.7% vs. 29.5%, P＜0.001), diffuse (87.1% vs. 75%, P＜0.001), and severe coronary artery spasm (51.6% vs. 43.5%, P=0.041) than patients without chest pain.
Conclusion: Ischemic ECG changes and chest pain during the Ach-provocation test are associatedwith multi-vessel involvement and severe coronary artery spasm. Chest pain is associated with the length of endothelial dysfunction, but ischemic ECG change is not.
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KEYWORD
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ECG change, Chest pain, Ach-induced endothelial dysfunction
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