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Myocardial infarct with normal coronary vessels: an association with dysfunction of the coronary microcirculation

Title: Myocardial infarct with normal coronary vessels: an association with dysfunction of the coronary microcirculation
Authors: Di Clemente D.; Borghi A.; Morgagni G. L.; Costa G. M.; Rusticali G.; Bugiardini R.
Contributors: Di Clemente D.; Borghi A.; Morgagni G.L.; Costa G.M.; Rusticali G.; Bugiardini R.
Publication Year: 1994
Collection: IRIS Università degli Studi di Bologna (CRIS - Current Research Information System)
Subject Terms: Adult; Aged; Animal; Cardiac Pacing; Artificial; Chi-Square Distribution; Coronary Circulation; Coronary Vessel; Cricetinae; Female; Heart Catheterization; Hemodynamic Processe; Human; Male; Microcirculation; Middle Aged; Myocardial Infarction
Description: The association of acute myocardial infarction (AMI) with normal coronary arteries was analyzed prospectively. A series of 128 consecutive patients underwent coronary angiography within 1 week from AMI. Seven patients, all females, had no coronary artery lesions and were considered eligible for the study. All 7 patients underwent atrial pacing (10 g/min increments every 2 min), ergonovine testing (E; total dose 0.650 mg i.v.). Great cardiac vein flow (GCVF; thermodilution technique), mean aortic pressure (MAP), anterior coronary resistance (ACR) and myocardial lactate extraction [(Lac art-Lac gcv)/Lac art] were measured at baseline and during testing. Pacing-induced typical chest pain occurred in 5 patients: 4 of them showed concurrent significant (> or = 0.15 mV) ST downsloping. At peak pacing, GCVF increased only by < 50%, or even decreased, in all patients. Baseline lactate extraction (0.13 +/- 0.11) changed to lactate production (-0.15 +/- 0.10) in 7/7 patients. None of the patients showed focal epicardial coronary artery spasm following E. During testing, however, all 7 patients showed decrease in GCVF (110 +/- 47 versus 74 +/- 21; p < 0.005), increase in ACR (0.92 +/- 0.29 versus 1.43 +/- 0.20; p < 0.001), and significant coronary lactate production (-0.18 +/- 0.12). Six patients referred slight to moderate chest pain, which was accompanied by ST downsloping in 4.(ABSTRACT TRUNCATED AT 250 WORDS)
Document Type: article in journal/newspaper
File Description: STAMPA
Language: Italian
Relation: info:eu-repo/semantics/altIdentifier/pmid/7781000; volume:39; issue:12; firstpage:827; lastpage:834; numberofpages:8; journal:CARDIOLOGIA; https://hdl.handle.net/11585/954334
Availability: https://hdl.handle.net/11585/954334
Accession Number: edsbas.F38CCCC0
Database: BASE