CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

SPECT and PET in ischemic heart failure The Prevalence of Myocardial Bridging Associated with Coronary Endothelial Dysfunction in Patients with Chest Pain and Non-Obstructive Coronary Artery Disease A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies Timing of Intervention in Aortic Stenosis Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention Association Between Functional Impairment and Medication Burden in Adults with Heart Failure Baseline Features of the VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) Trial Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction

Original Research2019 Mar 9. [Epub ahead of print]

JOURNAL:Am J Cardiol. Article Link

Prevalence of Coronary Vasospasm Using Coronary Reactivity Testing in Patients With Spontaneous Coronary Artery Dissection

Solaru KW, Heupler F, Kim ESH et al. Keywords: spontaneous coronary artery dissection; prevalence; MI, sudden cardiac death; coronary vasospasm

ABSTRACT


Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction and sudden cardiac death, particularly in young to middle-aged women. Coronary vasospasm is another condition believed to be associated with SCAD; however, this has only been shown in isolated case reports to date. We sought to examine the association of SCAD and coronary vasospasm by reporting the experience of coronary vasospasm testing in patients with a history of previous SCAD in a large, tertiary referral center. We conducted a single-center retrospective review of patients with history of SCAD confirmed by angiography who received provocative testing using ergonovine in the Cleveland Clinic cardiac catheterization lab from January 1990 to December 2016. Positive vasospasm was defined as: (1) total or subtotal occlusion of at least 1 major coronary artery induced by administration of ergonovine and (2) resolution of said occlusion with the administration of nitrates. Patients with history of strong trauma to the chest and iatrogenic dissection (e.g., catheter-induced) were excluded from the study. We identified 11 patients who satisfied all inclusion criteria. All participants were women and the mean age was 47 years: 73% received screening for fibromuscular dysplasia and of those, 38% were found to have the diagnosis. Only 1 of 11 patients had a positive vasospasm test in the setting of ergonovine administration in the catheterization lab. In conclusion, we found a low prevalence of coronary vasospasm in individuals with confirmed previous SCAD.