title: Correlation of angiographic morphology immediately after coronary balloon angioplasty with coronary vasomotion late after angioplasty.
abstract: BACKGROUND
  Various vasomotor responses to acetylcholine have been observed after coronary angioplasty. However, the relationship between the grade of vascular injury due to balloon angioplasty and vasomotor response to acetylcholine in the chronic stage is unknown. In this study we examined the correlation between the morphology immediately after coronary angioplasty and the vasomotor response to acetylcholine 1 year after angioplasty.
  
  
  METHODS
  Thirty nine patients with a total of 45 coronary lesions without restenosis 1 year after angioplasty were studied. The 45 lesions were divided into two groups according to the morphology immediately after angioplasty. Group A comprised smooth-walled dilation and smooth-walled dilation with intraluminal haziness which were considered to be related to injury limited to the intima or the surface of the media. Group B comprised intraluminal and extraluminal haziness and extraluminal type dissection which were considered to be related to extensive medial injury. In the 39 patients, acetylcholine provocation test was performed.
  
  
  RESULTS
  Transient total occlusion of angioplasty site was induced by acetylcholine in four lesions only in Group A. Percent change in coronary diameter after acetylcholine injection relative to that after injection of isosorbide dinitrate at the angioplasty site was larger in Group A than that of Group B.
  
  
  CONCLUSIONS
  In the chronic stage, vessels with minor vascular injury exhibited a large vasomotor response to acetylcholine; conversely, the response was low in vessels with severe vascular injury by angioplasty. These observations suggest that severe vascular injury by balloon angioplasty may control coronary vasomotion in the chronic stage.
authors.affiliation: Cardiovascular Division, Department of Medicine II, Kansai Medical University, 10-15 Fumizonocho, Moriguchi City, Osaka 570-8507, Japan. sutaniy@takii.kmu.ac.jp
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sutani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kamihata
authors.forename: Syuji
authors.initials: S
authors.lastname: Ueda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
mesh_terms: D000109:Acetylcholine; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries* / Q000473:pathology; D004730:Endothelium, Vascular / Q000293:injuries* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014661:Vasoconstriction; D014664:Vasodilation
chemical_list: D000109:Acetylcholine