Author + information
- Received August 12, 1982
- Revision received November 3, 1982
- Accepted November 5, 1982
- Published online March 1, 1983.
- Alan B. Schwartz, MD,
- T.A. Donmichael, MD, FACC,
- Elias H. Botvinick, MD, FACC,
- T. Ishimori, MD, FACC,
- William W. Parmley, MD, FACC and
- Kanu Chatterjee, MB, FRCP, FACC*
- ↵*Address for reprints: Kanu Chatterjee, MB, FRCP, Professor of Medicine, Lucie Stern Professor of Cardiology, University of California, San Francisco, California 94143.
Because an increase in coronary vascular resistance in response to ergonovine maleate has been suggested as a possible diagnostic aid for variant angina, changes were evaluated in coronary hemodynamics and serial myocardial thallium-201 perfusion scans in 15 patients without angina and with normal coronary arteries in response to ergonovine (0.05, 0.10 and 0.20 mg intravenously). For the group, heart rate-blood pressure product increased significantly (p < 0.001) without any change in coronary sinus flow, coronary vascular resistance, myocardial oxygen extraction, arterial-coronary sinus oxygen difference and lactate extraction. In 7 of 15 patients, however, coronary vascular resistance increased (mean 39%, range 11 to 75%, probability [p] < 0.001), and coronary sinus flow decreased (14%, p < 0.001), despite an increase in heart rate-blood pressure product (36%, p < 0.02). No electrocardiographic, metabolic or thallium-201 scan abnormalities occurred. Therefore, significant increases in coronary vascular resistance in response to ergonovine may occur in patients with normal coronary arteries and atypical chest pain.
- Received August 12, 1982.
- Revision received November 3, 1982.
- Accepted November 5, 1982.
- American College of Cardiology Foundation