title: Left ventricular end diastolic pressure for detection of intracoronary ergonovine-induced myocardial ischemia.
abstract: BACKGROUND
  Recent consensus on variant angina defines significant spasm as total or subtotal occlusion of a coronary artery. However, the clinical significance of "less-than-subtotal" spasm needs to be reappraised, especially if the coronary spasm is combined with chest pain. Therefore, we evaluated the feasibility of left ventricular end diastolic pressure (LVEDP) as a tool to detect myocardial ischemia during ergonovine provocation testing.
  
  
  METHODS
  After achieving two access sites, 29 patients underwent successful LVEDP monitoring using 5-Fr pigtail catheters during ergonovine provocation tests. Patients were divided into two groups based on the occurrence of anginal symptoms.
  
  
  RESULTS
  Of the 29 patients, 16 (55 %) patients had anginal symptoms. LVEDP was significantly increased in the symptomatic group compared with the nonsymptomatic group (∆LVEDP 5.6 ± 4.2 vs. 1.2 ± 2.0 mmHg, p = 0.002). However, of the 16 patients with anginal symptoms, positive provocation test results were confirmed in only six patients (38 %) as per the traditional standard (> 90 % inducible spasm of the epicardial coronary artery).
  
  
  CONCLUSIONS
  Compared with the traditional standard, LVEDP may have advantages in terms of elucidating anginal symptoms in patients suspected of having coronary vasospasm when performing ergonovine provocation tests.
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea. sch.kimtaehoon@gmail.com.
authors.forename: T-H
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Kwon
authors.affiliation: Division of Neurology, Inje University Seoul Paik Hospital, Seoul, Republic of Korea.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: R K
authors.initials: RK
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Sejong General Hospital, Bucheon-si, Gyeonggi-do Korea, Republic of Korea.
authors.forename: W-H
authors.initials: WH
authors.lastname: Shim
mesh_terms: D000788:Angina Pectoris, Variant / Q000175:diagnosis*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods*; D003331:Coronary Vessels / Q000187:drug effects; D004874:Ergonovine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D014662:Vasoconstrictor Agents; D004874:Ergonovine
keywords: Ergonovine provocation test; Left ventricular end diastolic pressure; Myocardial ischemia; Variant angina; Vasospastic angina