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Futoshi Yamanaka, Koki Shishido, Tomoki Ochiai, Noriaki Moriyama, Kazuki Tobita, Tomoyuki Tani, Kyosuke Furuhashi, Kazuya Sugitatsu, Daisuke Hachinohe, Tadashi Wada, Shingo Mizuno, Hidetaka Suenaga, Yutaka Tanaka, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shinji Tanaka, Shigeru Saito
OBJECTIVE: Multi-slice computed tomography (MSCT) coronary angiography has been reported as an effective alternative to invasive conventional coronary angiography (CCA) for the diagnosis of coronary artery disease (CAD). However, in previous reports, the diagnostic accuracy of MSCT has not been significant enough to be of benefit in symptomatic patients. The aim of this study was to identify the usefulness of 320-slice computed tomography coronary angiography (320-CTA) for symptomatic patients in terms of the diagnostic accuracy of 320-CTA and the prevalence of vasospastic angina pectoris (VSAP) within the study cohort...
September 29, 2016: European Journal of Internal Medicine
Min Seok Oh, Jeong Hoon Yang, Da Hyun Lee, Taek Kyu Park, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
BACKGROUND: Limited data are available on the efficacy of statin therapy for secondary prevention in patients with vasospastic angina (VSA). We investigated the association of statin therapy with long-term clinical outcomes in VSA patients without significant coronary artery disease. METHODS: From January 2003 to June 2014, we enrolled a total of 804 patients with VSA proven by an ergonovine provocation test without significant (≥70% diameter stenosis) coronary artery disease...
November 15, 2016: International Journal of Cardiology
Tsuyoshi Ito, Hiroshi Fujita, Taku Ichihashi, Nobuyuki Ohte
OBJECTIVE: Endothelial dysfunction of the coronary artery is thought to lead to the development of coronary spasms. Epicardial adipose tissue may be a marker of coronary atherosclerosis. This study investigated the diagnostic impact of epicardial fat volume (EFV), quantified with non-contrast electrocardiogram (ECG)-gated computed tomography (CT), on ergonovine-induced coronary spasms. METHODS: We included 97 patients with suspected coronary spastic angina who underwent ECG-gated CT and an ergonovine provocation test...
October 15, 2016: International Journal of Cardiology
A Young Lim, Taek Kyu Park, Sung Woo Cho, Min Seok Oh, Da Hyon Lee, Choong Sil Seong, Hye Bin Gwag, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joonghyun Ahn, K C Carriere, Seung-Hyuk Choi
BACKGROUND: High-dose aspirin has been reported to exacerbate coronary artery spasm in patients with vasospastic angina. We investigated clinical implications of low-dose aspirin on vasospastic angina patients without significant coronary artery stenosis. METHODS: We included patients without significant coronary artery stenosis on coronary angiography (CAG) and with positive results on intracoronary ergonovine provocation test between January 2003 and December 2014...
October 15, 2016: International Journal of Cardiology
Eun-Ju Kang, Moo Hyun Kim, Cai De Jin, Jeongmin Seo, Dong Won Kim, Seong Kuk Yoon, Tae-Ho Park, Ki-Nam Lee, Sang Il Choi, Yeonyee Elizabeth Yoon
OBJECTIVES: To evaluate the feasibility of a double-acquisition coronary CT angiography (CCTA) protocol in the presence and absence of an intravenous (IV) vasodilator infusion for detecting vasospastic angina. METHODS: Twenty patients with a high clinical probability of vasospastic angina were enrolled. All subjects underwent baseline CCTA without a vasodilator in the early morning followed by a catheterized coronary angiography with ergonovine provocation test...
July 6, 2016: European Radiology
Berrin Günaydın, Mertihan Kurdoğlu, İsmail Güler, Mehrnoosh Bashiri, Fırat Büyüktaşkın, Mine Dağgez Keleşoğlu, Gözde İnan
Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 μg and morphine 150 μg were intrathecally administered for spinal anaesthesia...
February 2016: Turkish Journal of Anaesthesiology and Reanimation
Tomonari Koike, Shiori Tamura, Ying Yu, Nobue Kuniyoshi, Masashi Shiomi
We examined the relationship between atherosclerosis and the provocation of coronary spasm as well as the influence of coronary spasm on the onset of acute ischemic myocardial disease. Coronary spasm was provoked in anesthetized normal Japanese white (JW) rabbits and myocardial infarction-prone Watanabe heritable hyperlipidemic (WHHLMI) rabbits, an animal model for coronary atherosclerosis and myocardial infarction, by injecting ergonovine during the infusion of norepinephrine through a marginal ear vein. A decrease in contrast flow in the left circumflex artery was observed on coronary angiograms...
June 14, 2016: Experimental Animals
Shozo Sueda, Hiroaki Kohno
Pharmacological spasm provocation tests are invasive methods and we always have the potential to encounter complications when performing these tests. In 1980, Buxton et al. reported three deaths when they performed intravenous ergonovine testing. However, we now employ the intracoronary ergonovine test instead of the intravenous injection of ergonovine from a safety procedure point of view. Past serious major complications of intravenous ergonovine tests, intracoronary ergonovine tests, and intracoronary acetylcholine tests were 0...
July 2016: Journal of Cardiology
Mi-Hyang Jung, Dong Il Shin, Ik Jun Choi, Suk Min Seo, Sooa Choi, Mahn Won Park, Pum-Joon Kim, Sang Hong Baek, Ki-Bae Seung
PURPOSE: The association between the red cell distribution width (RDW) and vasospastic angina (VSA) has not been elucidated. We investigated the association of the RDW with the incidence and angiographic subtypes of VSA in Korean patients. MATERIALS AND METHODS: A total of 460 patients who underwent intracoronary ergonovine provocation tests were consecutively enrolled and classified into two groups: the VSA group (n=147, 32.0%) and non-VSA group (n=313, 68.0%)...
May 2016: Yonsei Medical Journal
Erin Rayner-Hartley, Annie Chou, Jacqueline Saw, Tara Sedlak
Kounis syndrome is defined as an acute coronary syndrome triggered by allergic or hypersensitivity reactions resulting in mast cell and platelet activation. Numerous causes have been described, including various drugs, medical conditions, and environmental exposures. Samter's triad consists of nasal polyps, asthma, and aspirin (or nonsteroidal anti-inflammatory drug) sensitivity. We describe a case of Kounis type I in a young woman with Samter's triad who presented with cardiac arrest on 3 occasions. Ergonovine provocation testing established the diagnosis of coronary vasospasm...
December 18, 2015: Canadian Journal of Cardiology
Soo Jin Kim, Ji Young Juong, Tae-Ho Park
A 68-year-old man was admitted for a syncope workup. After routine evaluation, he was diagnosed with syncope of an unknown cause and was discharged from the hospital. He was readmitted due to dizziness. On repeated Holter monitoring, polymorphic ventricular tachycardia was detected during syncope. We performed intracoronary ergonovine provocation test; severe coronary spasm was induced at 70% stenosis of the proximal left anterior descending artery. The patient was treated with percutaneous coronary intervention...
January 2016: Korean Circulation Journal
H-J Jang, T-H Kim, S W Kwon, J-Y Kim, J S Kim, H J Lee, J S Park, R K Choi, Y J Choi, W-H Shim
BACKGROUND: Recent consensus on variant angina defines significant spasm as total or subtotal occlusion of a coronary artery. However, the clinical significance of "less-than-subtotal" spasm needs to be reappraised, especially if the coronary spasm is combined with chest pain. Therefore, we evaluated the feasibility of left ventricular end diastolic pressure (LVEDP) as a tool to detect myocardial ischemia during ergonovine provocation testing. METHODS: After achieving two access sites, 29 patients underwent successful LVEDP monitoring using 5-Fr pigtail catheters during ergonovine provocation tests...
June 2016: Herz
Alan K Jarmusch, Ashleigh M Musso, Tatsiana Shymanovich, Scott A Jarmusch, Miranda J Weavil, Mary E Lovin, Brandie M Ehrmann, Susanna Saari, David E Nichols, Stanley H Faeth, Nadja B Cech
Ergot alkaloids are mycotoxins with an array of biological effects. With this study, we investigated for the first time the application of atmospheric pressure photoionization (APPI) as an ionization method for LC-MS analysis of ergot alkaloids, and compared its performance to that of the more established technique of electrospray ionization (ESI). Samples of the grass Achnatherum robustum infected with the ergot producing Epichloë fungus were extracted using cold methanol and subjected to reserved-phase HPLC-ESI-MS and HPLC-APPI-MS analysis...
January 5, 2016: Journal of Pharmaceutical and Biomedical Analysis
Shozo Sueda, Hiroaki Kohno, Takaaki Ochi, Tadao Uraoka
The acetylcholine (ACh) spasm provocation test proposed by Yasue, Okumura et al more than a quarter-century ago has become a popular method for induction of coronary spasm. This test is safe and has a low rate of complications. However, it may be limited in its ability to document attacks in daily life because previously it was the gold-standard method for diagnosing active variant angina. There may be some clinical issues to modify for the next generation of cardiologists. A maximal ACh dose of 50/100 µg in the right coronary artery/left coronary artery is recommended in the Japanese Circulation Society guidelines...
July 2015: Clinical Cardiology
Sven Dänicke
Hardened sclerotia (ergots) of Claviceps purpurea contaminate cereal grains and contain toxic ergot alkaloids (EA). Information on EA toxicity in ducks is scarce. Therefore, the aim of the growth experiment (Day 0-49, n = 54/group) was to titrate the lowest observed adverse effect level (LOAEL) for total ergot alkaloids (TEA). A control diet was prepared without ergots, and the diets designated Ergot 1 to 4 contained 1, 10, 15 and 20 g ergot per kg diet, respectively, corresponding to TEA contents of 0.0, 0...
June 2015: Toxins
Dong Il Shin, Sang Hong Baek, Sung Ho Her, Seung Hwan Han, Youngkeun Ahn, Keun-Ho Park, Dong-Soo Kim, Tae-Hyun Yang, Dong-Ju Choi, Jung-Won Suh, Hyuck Moon Kwon, Byoung Kwon Lee, Hyeon-Cheol Gwon, Seung-Woon Rha, Sang-Ho Jo
OBJECTIVES: This study was an observational, multicenter registry to determine clinical characteristics and 24-month prognosis of patients who underwent intracoronary ergonovine provocation tests. BACKGROUND: The clinical characteristics and prognosis of patients who underwent the ergonovine provocation for vasospastic angina were not fully elucidated. METHODS: A total of 2,129 patients in the VA-KOREA (Vasospastic Angina in Korea) registry were classified into positive (n = 454), intermediate (n = 982), and negative (n = 693) groups by intracoronary ergonovine provocation tests...
June 2015: JACC. Cardiovascular Interventions
Shozo Sueda, Toru Miyoshi, Yasuhiro Sasaki, Tomoki Sakaue, Hirokazu Habara, Hiroaki Kohno
OBJECTIVE: We examined the clinical usefulness of sequential spasm provocation tests as follows: first, acetylcholine (ACh) test, second, ergonovine (ER) test, and finally, the ACh test following the ER test. PATIENTS AND METHODS: We performed the ACh and ER tests in 461 patients (294 men, 64.4±11.3 years of age) during a 23-year period. In addition, we administered an intracoronary injection of ACh after the ER tests in 240 patients. First, ACh [right coronary artery (RCA): 20/50/(80) μg, left coronary artery (LCA): 20/50/100/(200) μg] was administered incrementally over 20 s...
September 2015: Coronary Artery Disease
Woong Choi, Yu Na Kim, Kyung-Hee Kim
INTRODUCTION: Moyamoya disease is characterized by progressive steno-occlusive changes of the distal internal carotid and developed collateral vasculature, so called 'moyamoya' vessels at the base of the brain. Variant angina is a rare occurrence in patients with moyamoya disease. CASE PRESENTATION: Here we report the case of a 41-year-old Korean woman who developed chest pain after indirect revascularization surgery of moyamoya disease. A treadmill test and an exercise stress echocardiograph showed positive results, but there was no significant major coronary arteries stenosis...
2015: Journal of Medical Case Reports
Mrinalini Balki, Magda Erik-Soussi, Nivetha Ramachandran, John Kingdom, Jose C A Carvalho
BACKGROUND: The objective of this study was to compare the in vitro contractile effects of the combination of oxytocin (low dose and high dose) with either ergonovine or carboprost in myometrial strips from women undergoing cesarean delivery (CD), and to study the effect of oxytocin pretreatment on these contractions. We hypothesized that the use of ergonovine or carboprost in combination with oxytocin would improve contractility compared with oxytocin alone. METHODS: Myometrial samples obtained from women undergoing elective CD were pretreated in organ bath chambers with either oxytocin 10 M (experimental) or physiological salt solution (control) for 2 hours...
May 2015: Anesthesia and Analgesia
Charles F Rosenkrans, Nicholas S Ezell
Determining a grazing animal's susceptibility to ergot alkaloids has been a research topic for decades. Our objective was to determine if the Promega™ P450-Glo assay could be used to indirectly detect ergot alkaloids or their metabolites in urine of steers. The first experiment validated the effects of ergot alkaloids [0, 20, and 40 μM of ergotamine (ET), dihydroergotamine (DHET), and ergonovine (EN)] on human CYP3A4 using the P450-Glo assay (Promega™ V9800). With this assay, luminescence is directly proportional to CYP450 activity...
2015: Frontiers in Chemistry
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