title: Noninvasive prediction of angiographic spasm provocation using trans-thoracic Doppler echocardiography in patients with coronary spastic angina.
abstract: BACKGROUND
  In the present study it was examined whether transthoracic Doppler echocardiography (TTDE) would be useful for noninvasive diagnosis of coronary spastic angina (CSA) by assessing coronary arterial tone in the morning.
  
  
  RESULTS
  The study population comprised 21 CSA patients and 27 control subjects. All diagnoses were angiographically confirmed by provocation test using acetylcholine. Coronary flow velocity reserve (CFVR) was measured at the distal left anterior descending artery with a frequency of 5.0 MHz ultrasound at baseline and after sublingual administration of nitroglycerin (NTG). Coronary arterial tone was assessed by obtaining the change of CFVR induced by NTG administration (CFVR(NTG/Pre)). Basal CFVR tended to be lower in CSA patients (2.13+/-0.63, 2.71+/-0.67, respectively, p = 0.05). CFVR after NTG was significantly higher in CSA patients (3.91+/-1.10, 3.07+/-0.74, p = 0.003). The CFVR(NTG/Pre) was significantly higher in CSA patients than in the control subjects (1.90+/-0.49, 1.15+/-0.22, p < 0.0001). Using a cut-off value of 1.4 in CFVR(NTG/Pre), the sensitivity and specificity for the diagnosis of CSA were 91% and 90%, respectively.
  
  
  CONCLUSIONS
  TTDE appeared to be useful for the noninvasive diagnosis of CSA by assessing the coronary arterial tone.
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. mtakagi@hij.twmu.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takagi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Arai
authors.forename: Motoko
authors.initials: M
authors.lastname: Hosaka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Kazue
authors.initials: K
authors.lastname: Gunnji
authors.forename: Kyomi
authors.initials: K
authors.lastname: Tanimoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Ishizuka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tsurumi
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara