[Coronary flow after successful angioplasty in patients with acute myocardial infarction: comparison between coronary flow reserve by nicorandil and papaverine].
In order to evaluate coronary flow response to 2 different vasodilators, nicorandil and papaverine, in patients with myocardial infarction, we measured coronary flow reserve using a Doppler guide wire in infarct-related and non infarct-related arteries. The study group consisted of 28 patients with first acute myocardial infarction 3 weeks after successful coronary angioplasty within 6 hr after symptom onset. Twelve patients with atypical chest pain served as the control group. Coronary flow reserve induced by intracoronary papaverine(12 mg) was lower in infarct-related arteries than in non infarct-related arteries, but there were no differences in coronary flow reserve induced by intracoronary nicorandil(1 mg) between infarct-related and non infarct-related arteries. Coronary flow reserve induced by nicorandil was lower than that by papaverine in non infarct-related arteries and the control group. However, there were no differences between coronary flow reserve induced by nicorandil and papaverine in infarct-related arteries. Vasodilatory response induced by nicorandil was relatively preserved in infarct-related arteries compared with papaverine. These results suggest that impairment of coronary microvascular response in infarct myocardium varies in the different sites acted on by different vasodilator agents.
Izumi
C
C
Department of Cardiology, Tenri Hospital, Nara.
Kondo
H
H
Tamura
T
T
Inoko
M
M
Kitaguchi
S
S
Hirozane
T
T
Himura
Y
Y
Iga
K
K
Gen
H
H
Konishi
T
T
D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D020108:Nicorandil / Q000494:pharmacology*; D010208:Papaverine / Q000494:pharmacology*; D014465:Ultrasonics; D014665:Vasodilator Agents / Q000494:pharmacology*
D014665:Vasodilator Agents; D020108:Nicorandil; D010208:Papaverine