Overview of the pharmacological spasm provocation test: Comparisons between acetylcholine and ergonovine

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• 作者：Shozo Sueda ; MD ; FJCC^a ; ^{EZF03146@nifty.com} ; Hiroaki Kohno ; MD^b ; Takaaki Ochi ; MD^c ; Tadao Uraoka ; MD^d ; Kensuke Tsunemitsu ; MD^e
• 关键词：Acetylcholine ; Ergonovine ; Spasm ; Vasospastic angina
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：69
• 期：1
• 页码：57-65
• 全文大小：502 K
• 卷排序：69

文摘

The spasm provocation tests of ergonovine and acetylcholine have been employed in the cardiac catheterization laboratory. Ergonovine acts through the serotogenic receptors, while acetylcholine acts through the muscarinic cholinergic receptors. Different mediators may have the potential to cause different coronary responses. However, there are few reports concerning the coronary response between ergonovine and acetylcholine in the same patients. Acetylcholine is supersensitive for females; spasm provoked by ergonovine is focal and proximal, whereas provoked spasm by acetylcholine is diffuse and distal. We should use both tests as supplementary in the clinic because ergonovine and acetylcholine have self-limitations to induce coronary spasms during daily life. The maximal pharmacological doses, administration methods, and the angiographical positive definition are remarkably different for each institution in the world. We recommend the pharmacological spasm provocation tests as Class I in the guidelines in patients with vasospastic angina throughout the world.