Teragawa H, Oshita C, Uchimura Y. Does the intracoronary pressure differ according to two types (diffuse or focal) of coronary spasm? World J Cardiol 2023; 15(1): 1-12 [PMID: 36714369 DOI: 10.4330/wjc.v15.i1.1]
Corresponding Author of This Article
Hiroki Teragawa, FACC, FACP, FAHA, FESC, MD, PhD, Chief Physician, Doctor, Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-Ku, Hiroshima, 732-0057, Japan. hiroki-teragawa@jrhh.or.jp
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Jan 26, 2023; 15(1): 1-12 Published online Jan 26, 2023. doi: 10.4330/wjc.v15.i1.1
Table 1 Patients characteristics
Group D
Group F
P value
No. (%)
54 (62)
33 (38)
Age (yr)
65 ± 11
69 ± 10
0.06
Male/Female
28/26
22/11
0.18
BMI (kg/m2)
24.4 ± 4.2
24.7 ± 3.4
0.77
Coronary risk factors (%)
Current smoker
11 (20)
8 (24)
0.67
Hypertension
34 (63)
27 (82)
0.06
Dyslipidemia
36 (67)
19 (58)
0.39
Diabetes mellitus
10 (19)
9 (27)
0.34
Family history of CAD (%)
12 (22)
8 (24)
0.83
MtS (%)
12 (22)
14 (42)
0.04
CKD (%)
16 (30)
13 (39)
0.35
Table 2 The results of blood chemical and echographic parameters in the 2 groups
Group D
Group F
P value
Blood chemical parameters
Total cholesterol (mg/dL)
193 ± 33
202 ± 40
0.26
Triglyceride (mg/dL)
142 ± 76
143 ± 58
0.93
HDL-cholesterol (mg/dL)
57 ± 17
57 ± 17
0.99
LDL-cholesterol (mg/dL)
107 ± 25
116 ± 32
0.16
Fasting blood sugar (mg/dL)
103 ± 30
107 ± 15
0.53
Hemoglobin A1c (%)
5.8 ± 0.9
6.1 ± 0.8
0.18
C-reactive protein (mg/dL)
0.06 (0.04, 0.18)
0.07 (0.02, 0.17)
0.74
Brain natriuretic peptide (pg/mL)
16 (10, 35)
20 (10, 30)
0.92
eGFR (mL/min/1.73 m2)
70.7 ± 14.5
67.8 ± 14.8
0.37
Echographic parameters
LVEF on UCG (%)
66 ± 9
67 ± 6
0.61
FMD on brachial ultrasonography (%)
3.9 ± 2.8 (n = 47)
2.8 ± 3.3 (n = 33)
0.11
NID on brachial ultrasonography (%)
15.2 ± 7.5 (n = 47)
12.3 ± 5.2 (n = 33)
0.05
Table 3 The results of VSA-related parameters in the 2 groups
Group D
Group F
P value
Medications taken before CAG
Calcium-channel blocker (%)
11 (20)
16 (48)
0.01
Long-acting nitrate (%)
6 (11)
9 (27)
0.05
Statins (%)
26 (48)
9 (27)
0.05
Anti-platelet therapy (%)
14 (26)
9 (27)
0.89
VSA-related symptom
Cold sweating or syncope (%)
5 (9)
4 (12)
0.67
CAG.SPT
Coronary atherosclerosis (%)
28 (52)
25 (76)
0.03
MB (%)
7 (13)
10 (30)
0.05
Multi-vessel spasm (%, n)
32 (74, 43)
19 (66, 29)
0.42
Table 4 Lesional characteristics in the diffuse and focal spasms
Diffuse spasm
Focal spasm
P value
No.
100
34
ST elevation on ECG during SPT
6 (6)
13 (35)
< 0.01
Total or subtotal occlusion on CAG
9 (9)
9 (26)
0.02
Spastic vessels: RCA/LAD
46/54
13/21
0.43
Spasm site
Proximal/Mid/Distal
12/57/31
5/16/13
0.58
Dose of ACh at spasm provocation
Low (%)/Moderate (%)/High (%)
32 (32)/65 (65)/3 (3)
13 (38)/16 (47)/5 (15)
0.03
Intracoronary pressure indexes
Baseline Pd/Pa
0.96 ± 0.05
0.95 ± 0.05
0.35
Minimal Pd/Pa
0.77 ± 0.11
0.66 ± 0.20
< 0.01
ΔPd/Pa
- 0.19 ± 0.11
- 0.29 ± 0.20
< 0.01
iFR (n)
0.96 ± 0.07 (n = 52)
0.95 ± 0.08 (n = 17)
0.83
FFR (n)
0.85 ± 0.08 (n = 26)
0.80 ± 0.10 (n = 8)
0.18
Table 5 Multivessel regression analysis for Δdistal pressure/aortic pressure during spasm provocation test
Factors
F value
P value
Focal spasm
14.14
< 0.01
Atherosclerosis
1.38
0.24
ACh dose at spasm provocation
1.08
0.34
R2 = 0.18
Citation: Teragawa H, Oshita C, Uchimura Y. Does the intracoronary pressure differ according to two types (diffuse or focal) of coronary spasm? World J Cardiol 2023; 15(1): 1-12