Effects of intravenous prostacyclin in variant angina.
- 1 March 1982
- journal article
- research article
- Published by Wolters Kluwer Health in Circulation
- Vol. 65 (3), 470-477
- https://doi.org/10.1161/01.cir.65.3.470
Abstract
A lack in prostacyclin (PGI2) production due to atherosclerosis may play a role in the pathophysiology of some of the clinical manifestations of ischemic heart disease and in particular, of coronary vasospasm. We therefore evaluated the effects of i.v. PGI2 in nine patients with variant angina and six normal volunteers. In normal subjects, PGI2 (2.5, 5, 10 and 20 micrograms/kg/min) had significant antiplatelet effects, caused a dose-dependent decrease in both systolic and diastolic arterial pressure and a decrease in pulmonary resistance. Heart rate increased in a dose-dependent manner, but no consistent effects on myocardial contractility (evaluated by ultrasound) were observed. Side effects were negligible and readily reversible. Although producing obvious antiplatelet and vasodilatory effects, PGI2 did not affect the number, severity and duration of spontaneous ischemic episodes due to coronary vasospasm in five patients and ergonovine-induced spasm in three. However, the number of ischemic episodes was consistently reduced in one patient during four consecutive periods of PGI2 infusion alternated with placebo. a severe, prolonged ischemic episode with ST elevation and pain was consistently observed in this patient every time PGI2 was discontinued. In the appropriate environment, PGI2 can be administered safely to patients with ischemic heart disease. Occasionally, PGI2 may result in a complete disappearance of ischemic episodes due to coronary vasospasm, but usually it is ineffective. These conflicting results could be related to different etiologies of coronary spasm.This publication has 33 references indexed in Scilit:
- Arachidonic Acid Metabolites and the Interactions between Platelets and Blood-Vessel WallsNew England Journal of Medicine, 1979
- Coronary Spasm and Acute Myocardial Infarction — New Possibility for Treatment and PreventionNew England Journal of Medicine, 1978
- “Variant” angina: One aspect of a continuous spectrum of vasospastic myocardial ischemiaThe American Journal of Cardiology, 1978
- Effects of prostacyclin on perfusion pressure, electrical activity, rate and force of contraction in isolated rat and rabbit heartsLife Sciences, 1978
- Cardiac and Coronary Prostaglandin Synthesis and FunctionNew England Journal of Medicine, 1978
- Coronary arterial spasm in Prinzmetal's angina: A proved hypothesisThe American Journal of Cardiology, 1976
- Transcutaneous aortovelography. A new window on the circulation?Heart, 1976
- Cyclic Fluctuations in Coronary Blood Pressure and Flow Induced by Coronary Artery ConstrictionJapanese Heart Journal, 1975
- Prinzmetal's variant form of angina with arteriographic evidence of coronary arterial spasmThe American Journal of Cardiology, 1972
- Measurement of blood flow by thermodilutionThe American Journal of Cardiology, 1972