Author + information
- Received March 2, 2011
- Revision received May 24, 2011
- Accepted June 14, 2011
- Published online October 4, 2011.
- Atsushi Tanaka, MD, PhD⁎,†,⁎ (, )
- Kenei Shimada, MD, PhD‡,
- Guillermo J. Tearney, MD, PhD⁎,†,§∥,
- Hironori Kitabata, MD¶,
- Haruyuki Taguchi, MD‡,
- Shota Fukuda, MD‡,
- Manabu Kashiwagi, MD¶,
- Takashi Kubo, MD¶,
- Shigeho Takarada, MD¶,
- Kumiko Hirata, MD, PhD¶,
- Masato Mizukoshi, MD, PhD¶,
- Junichi Yoshikawa, MD, PhD‡,
- Brett E. Bouma, PhD⁎,†,§ and
- Takashi Akasaka, MD, PhD¶
- ↵⁎Reprint requests and correspondence:
Dr. Atsushi Tanaka, Wellman Center for Photomedicine, Massachusetts General Hospital, 50 Blossom Street, Boston, Massachusetts 02114
Objectives The aim of this study was to investigate the conformational change of arterial structure in the vasospastic lesion with optical coherence tomography.
Background Coronary artery spasm plays an important role in the pathogenesis of ischemic heart diseases. The conformational change of each arterial layer during vasospasm has not been studied in detail.
Methods We assessed 19 coronary arteries (10 spasm and 9 nonspasm lesions) with optical coherence tomography during the provocation test for coronary spasm. An intimal bump was defined as 1 or more intimal projections into the lumen that disappeared after the administration of nitroglycerine (NTG). Intimal gathering was defined as a folding/gathering of the intima, resulting in multiple kinks in the luminal contour that resolved after the administration of NTG.
Results The spasm lesion more frequently showed an intimal bump at baseline and intimal gathering during spasm compared with the nonspasm lesion (spasm 80% vs. nonspasm 0%, p < 0.01, spasm 100% vs. nonspasm 0%, p < 0.01, respectively). The spasm lesion demonstrated a thicker maximum media thickness (spasm 0.24 ± 0.04 mm vs. nonspasm 0.12 ± 0.03 mm, p < 0.01) at baseline, whereas no differences were observed after the administration of NTG (spasm 0.13 ± 0.03 mm vs. nonspasm 0.13 ± 0.02 mm, p = 0.65).
Conclusions Our results suggest that medial contraction occurs even in an asymptomatic state and facilitates the formation of an intimal bump in patients with vasospastic angina. Luminal narrowing during spasm is associated with intimal gathering without alteration of intimal area.
Dr. Tearney is a consultant for Samsung; has performed sponsored research for the Terumo Corp.; and has received patent licensing and royalty income from the Terumo Corp. Dr. Bouma has a sponsored research agreement with and is an inventor on patents licensed to the Terumo Corp.; and is an inventor on patents licensed to LightLab Imaging. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 2, 2011.
- Revision received May 24, 2011.
- Accepted June 14, 2011.
- American College of Cardiology Foundation