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Coronary Vasomotor Responses to Intracoronary Acetylcholine

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Physiological Assessment of Coronary Stenoses and the Microcirculation

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Abstract

Coronary artery disease is a dynamic process with structural as well as functional vascular alterations affecting the whole coronary tree including the coronary microcirculation. The structural alterations of the epicardial arteries can be examined by visualization of the vessels using invasive or noninvasive coronary angiography. However, the functional alterations are more difficult to detect especially when the coronary microcirculation is involved. One established method to assess these functional disorders is intracoronary acetylcholine provocation testing. It has been shown that epicardial and/or microvascular spasms are present in up to 62 % of patients with angina pectoris and unobstructed coronary arteries. This chapter describes clinical scenarios where intracoronary acetylcholine provocation testing can be useful to detect a functional coronary vasomotor problem.

The authors declare that no conflict of interest exists in conjunction with the preparation of this chapter.

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Authors and Affiliations

  1. Department of Cardiology, Robert-Bosch Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Germany

    Peter Ong MD & Udo Sechtem MD

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  1. Peter Ong MD
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  2. Udo Sechtem MD
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Correspondence to Peter Ong MD or Udo Sechtem MD .

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Editors and Affiliations

  1. Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain

    Javier Escaned

  2. Imperial College London, London, United Kingdom

    Justin Davies

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Ong, P., Sechtem, U. (2017). Coronary Vasomotor Responses to Intracoronary Acetylcholine. In: Escaned, J., Davies, J. (eds) Physiological Assessment of Coronary Stenoses and the Microcirculation. Springer, London. https://doi.org/10.1007/978-1-4471-5245-3_20

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  • DOI: https://doi.org/10.1007/978-1-4471-5245-3_20

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  • Online ISBN: 978-1-4471-5245-3

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