Downloads
Abstract
Background: Coronary artery spasm is an important cause for anginal chest pain, but it is not appropriately estimated, in patients with angiographically non - obstructive coronary arteries. In acute coronary syndrome, coronary artery spasm is the cause of 49% of cases and appears in 30% of cases without the culprit artery. In addition, the elimination of coronary spasm on the narrow segment and the non-narrow segment helps to more accurately assess the degree of stenosis (%) of the lesion. So we implemened the study to find out the variation of coronary artery diameterbefore and after intra coronary nitrate injection.
Methods: A cross - sectional descriptive study was conducted on 40 patients diagnosed ischemic heart disease.
Results: The minimum diameter of the lumen artery significantly increased from 1.25 ± 0.35 mm to 1.56 ± 0.47 mm. Similarly, the area of the smallest lumen artery also increased from 1.32 ± 0.74 mm2 to 2.04 ± 1.26 mm2. The parameters of the coronary arterial lumen reference also increased significantly, from 2.84 ± 0.65 mm to 3.02 ± 0.70 mm for the diameter, and from 6.68 ± 3.05 mm2
to 7.56 ± 3.39 mm2 for area. Despite the dilation of the smallest lumen artery and the reference one, we recorded the diameter of stenosis (%) decreased from 55.85 ± 6.77% to 48.75 ± 9.13%. It is worth noting that there were more than 50% of cases showing the significant stenosis of diameter decreased to less than 50% of stenosis (in the stenosis group of no significance).
Conclusion: Intracoronary nitrate injection in coronary artery helps to accurately assess the stenosis and the diameter of the coronary artery
References
Ong P et al, Coronary artery spasm as a frequent cause of acute coronary syndrome: The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study. Journal of the American College of Cardiology, 2008. 52(7): p. 523-527.
Khổng Nam Hương, Nghiên cứu siêu âm trong lòng mạch (IVUS) trong đánh giá tổn thương động mạch vành và góp phần hướng dẫn điều trị can thiệp bệnh động mạch vành. Luận án tiến sĩ y học. Trường Đại học Y Hà Nội, 2014.
Maron DJ et al, Initial invasive or conservative strategy for stable coronary disease. New England Journal of Medicine, 2020. 382(15): p. 1395-1407.
Maas et al, Gender differences in coronary heart disease. Netherlands Heart Journal, 2010. 18(12): p. 598-603.
Nguyễn Minh Hùng và cs, Nghiên cứu hiệu quả điều trị một số tổn thương động mạch vành bằng phương pháp nong bóng có phủ thuốc. Luận án tiến sĩ y học. Đại học Y Hà Nội, 2019.
Nguyễn Quốc Thái và Nguyễn Lân Việt, Các yếu tố ảnh hưởng đến tái hẹp trong stent sau can thiệp ở các bệnh nhân nhồi máu cơ tim cấp. Tạp chí y học thực hành, 2011. 755(3): p. 81–84.
Vijayalakshmi K et al, Impact of catheter sizes and intracoronary glyceryl trinitrate on the TIMI frame count when digital angiograms are acquired at lower frame rates during elective angiography and PCI. Acute cardiac care, 2007. 9(4): p. 231-238.
Anderson RD et al, Coronary angiography: is it time to reassess? 2013, Am Heart Assoc. p. 1760-1762.
Briguori et al, Intravascular ultrasound criteria for the assessment of the functional significance of intermediate coronary artery stenoses and comparison with fractional flow reserve. The American journal of cardiology, 2001. 87(2): p. 136-141.
Tomai F et al, Unstable angina and elevated C-reactive protein levels predict enhanced vasoreactivity of the culprit lesion. Circulation, 2001. 104(13): p. 1471-1476.
Jost et al, How to standardize vasomotor tone in serial studies based on quantitation of coronary dimensions? The International Journal of Cardiac Imaging, 1998. 14(6): p. 357-372.
Hong et al, Intravascular ultrasound findings of negative arterial remodeling at sites of focal coronary spasm in patients with vasospastic angina. American heart journal, 2000. 140(3): p. 395-401.
| Published | 09-01-2025 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | No. 77 (2022) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.77.3 | |
| Keywords | Đường kính, co thắt, nitrat nội động mạch vành Diameter, spasm, intracoronary nitrate injection |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2022 Journal of Clinical Medicine Hue Central Hospital