Bronchial hyperresponsiveness to acetylcholine in patients with vasospastic angina pectoris.
OBJECTIVE
To investigate the similarity between coronary vasospasm and bronchial spasm.


METHODS
Nonrandomized, case-control study.


METHODS
Referral-based clinics for cardiac and pulmonary disease at one secondary care center.


METHODS
Seventeen patients with vasospastic angina pectoris (VSAP) and 14 patients with chest pain syndrome (CPS).


METHODS
Medications prohibited: those with known effects on bronchial responsiveness.


METHODS
Induction of coronary vasospasm: ergonovine maleate (10, 20, 40 micrograms) injection into coronary arteries during coronary angiography. Bronchial responsiveness to acetylcholine (ACh): acetylcholine chloride (0.08 to 20 mg/ml) inhalation and calculation of the provocative concentration of ACh (PC20-ACh) that revealed 20 percent fall in FEV1.


RESULTS
The median value for PC20-ACh in patients with VSAP, 7.80 mg/ml, was significantly lower than that in patients with CPS, > 20.0 mg/ml (p < 0.01 by Mann-Whitney U test). The PC20-ACh in patients with VSAP, however, was correlated neither with the responsive threshold of ergonovine maleate, which induced coronary vasospasm, nor with the duration from the latest angina attack.


CONCLUSIONS
These results suggest that bronchial responsiveness was increased in most patients with VSAP, but not with CPS. We therefore speculate that patients with VSAP may also have hypercontractibility to ACh of noncoronary systemic smooth muscles.
Saitoh
Y
Y
Third Department of Internal Medicine, Fukui Medical School, Japan.
Sasaki
F
F
Ishizaki
T
T
Miyabo
S
S
Kanamori
K
K
Mifune
J
J
D000109:Acetylcholine; D000328:Adult; D000368:Aged; D000403:Airway Resistance / Q000502:physiology; D000787:Angina Pectoris / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D001986:Bronchial Spasm / Q000503:physiopathology*; D016022:Case-Control Studies; D002637:Chest Pain / Q000503:physiopathology*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000503:physiopathology*; D004874:Ergonovine; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000502:physiology; D008875:Middle Aged; D012907:Smoking / Q000503:physiopathology; D013577:Syndrome; D014797:Vital Capacity / Q000502:physiology
D000109:Acetylcholine; D004874:Ergonovine