Coronary Reserve and Angina Therapy

  • M. Iriarte Ezkurdia
  • J. M. Aguirre Salcedo
  • J. Boveda Romeo
  • E. Molinero de Miguel
  • J. Urrengoetxea Martinez
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 81)


Several studies have confirmed that patients with vasospastic angina have a variable ischemia threshold for exercise [1–3]. In our group, Molinero has demonstrated [4, 5] that variable ischemia threshold, identified by different serial electrocardiographic effort tests, is frequent (12/20 cases) in patients with angina at rest and with exertion (mixed angina). Servi [1] identified a significant increment in exercise tolerance and regional coronary flow after administration of nifedipine in patients with effort angina and variable electrocardiographic threshold. Parting from these findings, our study had a double objective:
  1. a)

    identification of the vasospastic component of effort angina by evaluating coronary reserve, and

  2. b)

    appraisal of the therapeutic value of identifying this component.



Coronary Flow Coronary Blood Flow Effort Test Variable Threshold Coronary Artery Spasm 
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  1. 1.
    DeServi S, Specchia G, Falcone C, Gavazzi A, Mussini A, Angali C, Bramucci F, Ardissino B, Vaccari L, Salerno J, Bobba P: Variable threshold exertional angina in patients with transient vasospastic myocardial ischemia. Am J Cardiol 1983; 51: 397.CrossRefGoogle Scholar
  2. 2.
    Lentenegger F, Rafflenbeul W, Gahl K: Quantitative koronaroespasmen nach nifedippine. Schw Med Wschr 1980; 110: 1703.Google Scholar
  3. 3.
    Epstein SF, Talbot TL: Dynamic coronary tone in precipitation, exacerbation and relief of angina pectoris. Am J Cardiol 1981; 48: 797.PubMedCrossRefGoogle Scholar
  4. 4.
    Molinero E, Terradillos P, Faus JM, Fernandez L, Aguirre JM: Aproximación al diagnóstico fisiopatológico de la angina a través de las pruebas de esfuerzo seriadas. Rev Esp Cardiolog 1983; 36 (Suppl 2): 4.Google Scholar
  5. 5.
    Molinero E: Tesis doctoral. Universidad del Pais Vasco, Bilbao, 1983.Google Scholar
  6. 6.
    Maseri A, Chierchia S: Coronary artery spasm: demonstration, definition, diagnosis and consequences. Prog Cardiovasc Dis 1982; 25: 169–189.PubMedCrossRefGoogle Scholar
  7. 7.
    Maseri A, L’Abbate A, Chierchia S, et al.: Significance of spasm in the pathogenesis of ischemic heart disease. Am J Cardiol 1979; 42: 1019–1035.CrossRefGoogle Scholar
  8. 8.
    Maseri A, L’Abbate S, Denes M, et al.: Variant angina: one aspect of a continuous spectrum of vasospastic myocardial ischemia. Am J Cardiol 1975; 42: 1019–1035.CrossRefGoogle Scholar
  9. 9.
    Maseri A, L’Abbate A, Pesola A, et al.: Coronary vasospasm in angina pectoris. Lancet 1977; 1: 1034.Google Scholar
  10. 10.
    Iriarte MM, Boveda FJ, Aguirre JM, Faus JM, Martinez G, Molinero E, Negueruela J: Utilidad diagnóstica en la cardiopatia isquémica de la gammagrafia con Tl-201 a través de un programa de cuantificacién con ordenador. Rev Esp Cardiol 1985; 38: 92–99.Google Scholar
  11. 11.
    Heyndrickx GR, Myulaert P, Mabilde C, Pannier JL: Role of coronary α-receptors in the regulation of the coronary flow during exercise in dogs (Abstract). VIII European Congress of Cardiology. Paris, 1980: 135.Google Scholar
  12. 12.
    Murray PA, Vatner SE: a-receptor atentuation of coronary vascular response to severe, spontaneous exercise (Abstract). Fed Proc 1978; 37: 235.Google Scholar
  13. 13.
    Waters DD, Szlachcic J, Bourassa MG, Scholl JM, Theroux P: Exercise testing in patients with variant angina: results, correlation with clinical and angiographic features and prognostic significance. Circulation 1982; 65: 265–274.PubMedCrossRefGoogle Scholar
  14. 14.
    Fuller CM, Raizner AE, Chachine RA, et al.: Exercise-induced coronary arterial spasm: Angiographic demonstration, documentation of ischemia by myocardial scintigraphy and results of pharmacologic intervention. Am J Cardiol 1980; 46: 500–506.PubMedCrossRefGoogle Scholar
  15. 15.
    DeServi S, Specchia G, Curti MT, Falcone C, Gavazzi A, Bramucci E, Mussini A, Angoli L, Salerno J, Bobba P: Variable threshold of angina during exercise: a clinical manifestation of some patients with vasospastic angina. Am J Cardiol 1981; 48: 188–192.CrossRefGoogle Scholar
  16. 16.
    Conti RC, Pepine CJ, Felman RL: Coronary artery spasm by heart. Cardiol Ser 1981; 4: 7.Google Scholar
  17. 17.
    Yasue H, Omote S, Takizawa A, Nagao M, Miwa K, Tanaka S: Circadian variation of exercise capacity in patients with Prinzmetal variant angina: role of exercise-induced coronary arterial spasm. Circulation 1979; 59: 938–948.PubMedGoogle Scholar
  18. 18.
    Aguirre JM, Boveda FJ, Molinero E, Cid M, Arrillaga M, Urcengoetxea J, Iriarte M: Serial thallium 201 imaging: quantitative variable ischaemia threshold at rest and effort angina (Abstract). Eur Heart J 1984; 5 (Suppl 1).Google Scholar
  19. 19.
    Specchia G, DeServi S, Colomba F, Angeli L, Gavazzi A, Bramucci E, Mussini A, Ferrario M, Salerno J, Montemartini C: Effects of tidipine in coronary hemodynamic dinings during exercise in patients with stable exertional angina. Circulation 1983; 68: 5. 1035–1043.CrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • M. Iriarte Ezkurdia
  • J. M. Aguirre Salcedo
  • J. Boveda Romeo
  • E. Molinero de Miguel
  • J. Urrengoetxea Martinez

There are no affiliations available

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