title: Variability in coronary hemodynamics in response to ergonovine in patients with normal coronary arteries and atypical chest pain.
abstract: 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 less than 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] less than 0.001), and coronary sinus flow decreased (14%, p less than 0.001), despite an increase in heart rate-blood pressure product (36%, p less than 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.
mesh_terms: D000293:Adolescent; D000328:Adult; D003326:Coronary Circulation; D003327:Coronary Disease / Q000503:physiopathology; D003331:Coronary Vessels / Q000187:drug effects* / Q000502:physiology; D004874:Ergonovine / Q000494:pharmacology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007773:Lactates / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium; D014655:Vascular Resistance / Q000187:drug effects*
chemical_list: D007773:Lactates; D011868:Radioisotopes; D013793:Thallium; D004874:Ergonovine