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Abnormal Throughput Coronary Flow in Syndrome X

  • Takafumi Ueno
  • Akihiko Shiraishi
  • Kohji Hiyamuta
  • Hideki Yoshiyama
  • Akihiko Yamaga
  • Hidekatsu Maruyama
  • Masayoshi Yoh
  • Hisao Ikeda
  • Yoshinori Koga
  • Hironori Toshima

Abstract

To elucidate the mechanism of ST segment depression in patients with syndrome X, myocardial blood flow and myocardial O2 and lactate uptake were evaluated in 25 patients who had exhibited chest pain but had normal coronary arteriograms. Fourteen of the patients had chest pain and ST segment depression in an exercise stress test (SX), while the remaining 11 did not exhibit either of these symptoms (control). Atrial pacing induced significant ST segment depression in all patients with SX and did not do so in controls. There was no evidence of coronary artery spasm produced by intravenous administration of ergometrine maleate in any patients. Myocardial blood flow was measured with a Webster’s thermodilution catheter. Coronary flow reserve was defined as the increase occurring in coronary flow after the administration of intravenous dipyridamole (0.56 mg/kg), divided by coronary flow at rest. After the administration of dipyridamole, the coronary flow reserve was 2.70 in the SX group and 2.90 in the controls; this difference was not significant. During atrial pacing, there was a reduction of myocardial lactate uptake and a rise in left ventricular end-diastolic pressure in the SX group, but not in the controls. Oxygen saturation in coronary sinus blood did not change significantly in the controls, while it rose significantly in SX patients.

Keywords

Myocardial Blood Flow Coronary Flow Coronary Flow Reserve Myocardial Oxygen Consumption Exercise Stress Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • Takafumi Ueno
  • Akihiko Shiraishi
  • Kohji Hiyamuta
  • Hideki Yoshiyama
  • Akihiko Yamaga
  • Hidekatsu Maruyama
  • Masayoshi Yoh
  • Hisao Ikeda
  • Yoshinori Koga
  • Hironori Toshima
    • 1
  1. 1.Kurume University School of MedicineKurumeJapan

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