Does Coronary Microvascular Spasm Exist?Objective Evidence from Intracoronary Doppler Flow Measurements During Acetylcholine Testing  

作　　者：Fabian Guenther Andreas Seitz Valeria Martinez Pereyra Raffi Bekeredjian Udo Sechtem Peter Ong 

机构地区：[1]Department of Cardiology,Robert-Bosch-Krankenhaus,Auerbachstr.110,70376 Stuttgart,Germany

出　　处：《Cardiovascular Innovations and Applications》2020年第1期205-209,共5页心血管创新与应用（英文）

基　　金：This work was funded by the Robert Bosch Stiftung,Stuttgart,Germany,and the Berthold Leibinger Stiftung,Ditzingen,Germany.

摘　　要：A 43-year-old woman with recurrent atypical angina underwent invasive coronary angiography including intracoronary Doppler blood flow assessment and coronary spasm provocation testing.While obstructive epicardial disease could be ruled-out angiographically,the patient experienced reproduction of her angina symptoms after intracoronary administration of acetylcholine(100μg)during spasm provocation testing.Simultaneously,the ECG showed new-onset ST-segment depression in the absence of epicardial spasm.In addition,coronary fl ow velocity was signifi cantly reduced after acetylcholine compared to the baseline condition.Following intracoronary administration of nitroglycerine(200μg),the patient’s symptoms as well as the ECG changes and coronary flow reduction were reversed.Considering the ongoing challenges in appropriate evaluation of the pathophysiological mechanisms of coronary microvascular dysfunction,simultaneous intracoronary Doppler flow measurement during spasm testing–as shown in this case–may provide objective evidence for microvascular spasm in addition to the standardized diagnostic criteria,especially if they are ambiguous.

关 键 词：ACETYLCHOLINE CORONARY MICROCIRCULATION CORONARY flow reserve CORONARY SPASM 

分 类 号：R54[医药卫生—心血管疾病]