caa a22 4500 606220763 CHVBK 20210128101125.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00380-014-0563-y doi (NATIONALLICENCE)springer-10.1007/s00380-014-0563-y Maximal acetylcholine dose of 200μg into the left coronary artery as a spasm provocation test: comparison with 100μg of acetylcholine [Elektronische Daten] [Shozo Sueda, Hiroaki Kohno, Toru Miyoshi, Tomoki Sakaue, Yasuhiro Sasaki, Hirokazu Habara] As a spasm provocation test of acetylcholine (ACH), incremental dose up (20/50/100μg) into the left coronary artery (LCA) is recommended in the guidelines established by Japanese Circulation Society. Recently, Ong et al. reported the ACOVA study which maximal ACH dose was 200μg in the LCA. We compared the angiographic findings between ACH 100μg and ACH 200μg in the LCA and also examined the usefulness and safety of ACH 200μg in Japanese patients without variant angina. As a spasm provocation test, we performed intracoronary injection of ACH 200μg after ACH 100μg in 88 patients (55 males, 68.4±11.7years old) including 59 ischemic heart disease (IHD) patients and 29 non-IHD patients. Positive spasm was defined as >99% transient stenosis (focal spasm) or 90% severe diffuse vasoconstriction (diffuse spasm). Positive spasm by ACH 200μg was significantly higher than that by ACH 100μg (36 pts: 40.9% vs. 17 pts: 19.3%, p<0.01). Diffuse distal spasm on the left anterior descending artery was more recognized in ACH 200 μg than in ACH 100 μg (30.7 vs. 13.6%, p<0.01). In 29 rest angina patients, positive spasm by ACH 200μg (19 pts) was significantly higher than that by ACH 100μg (7 pts) (65.5 vs. 24.1%, p<0.01). No serious irreversible complications were found during ACH 200μg. Administration of ACH 200μg into the LCA was safe and useful. We may reexamine the maximal ACH dose into the LCA. Springer Japan, 2014 ACh 200μg nationallicence Maximal ACh dose in LCA nationallicence Positive spasm nationallicence Sueda Shozo The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut Kohno Hiroaki The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut Miyoshi Toru The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut Sakaue Tomoki The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut Sasaki Yasuhiro The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut Habara Hirokazu The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut Heart and Vessels Springer Japan 30/6(2015-11-01), 771-778 0910-8327 30:6<771 2015 30 380 https://doi.org/10.1007/s00380-014-0563-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0563-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sueda Shozo The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut NATIONALLICENCE 700 1- Kohno Hiroaki The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut NATIONALLICENCE 700 1- Miyoshi Toru The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut NATIONALLICENCE 700 1- Sakaue Tomoki The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut NATIONALLICENCE 700 1- Sasaki Yasuhiro The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut NATIONALLICENCE 700 1- Habara Hirokazu The Department of Cardiology, Ehime Niihama Prefectural Hospital, Hongou 3 choume 1-1, 792-0042, Niihama City, Ehime, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/6(2015-11-01), 771-778 0910-8327 30:6<771 2015 30 380