Skip to main content
SpringerLink
Log in

Responses of normal and obstructed coronary arterial segments to cold stimulation; a quantitative angiographic study

  • Chapter
Quantitative Coronary and Left Ventricular Cineangiography

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 51))

  • 27 Accesses

Summary

This study describes the quantitative coronary angiographic response to one minute hand immersion in ice water, the cold pressor test (CPT). The study population consisted of 20 patients with insignificant coronary disease (>50% diameter narrowing), 26 patients with exertional angina and 18 patients with angina at rest. A total of 49 obstructive lesions and 203 nonobstructed segments in the left coronary arterial system were analyzed with the CAAS.

Overall, CPT decreased the mean diameters of nonobstructed coronary segments from 2.76 to 2.68mm (−3%, p>0.001). Relative changes in mean coronary arterial dimensions were similar among the three groups of patients. The diameter of the left main artery was not influenced by CPT. The relative magnitude of change by CPT was greatest (−6%) in the distal segments of the circumflex artery.

The overall size of stenotic arterial segments demonstrated comparable vaso-constriction (−3%) as nonobstructed coronary segments. Focal spasm was not observed after CPT. Increases in percentages luminal narrowing at stenotic lesions never exceeded 25%. At the average, the minimal obstruction diameter increased slightly, but not significantly after CPT (1.47 vs 1.52mm, n.s.).

The results from this study thus indicate that CPT may not be a reliable provocative manoeuvre to induce focal coronary spasm.

This study was supported by the Dutch Heart Foundation under grant no. 82.058

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Epstein SE, Stampfer M, Beiser GD, Goldstein RE, Braunwald E: Effects of a reduction in environmental temperature on the circulatory response to exercise in man. Implications concerning angina pectoris. N Engl J Med 280: 7–11, 1969

    Article  PubMed  CAS  Google Scholar 

  2. Neill WA, Duncan DA, Kloster F, Mahler DJ: Response of coronary circulation to cutaneous cold. Am J Med 56: 471–476, 1974

    Article  PubMed  CAS  Google Scholar 

  3. Lassvik C, Areskog N-H: Angina pectoris during inhalation of cold air. Reactions to exercise. Br Heart J 43: 661–667, 1980

    Article  PubMed  CAS  Google Scholar 

  4. Hattenhauer M, Neill WA: The effect of cold air inhalation on angina pectoris and myocardial oxygen supply. Circulation 51: 1053–1058, 1975

    Google Scholar 

  5. Mudge GH Jr, Grossman W, Mills RM Jr, Lesch M, Braunwald E. Reflex increase in coronary vascular resistance in patients with ischemic heart disease. N Engl J Med 295: 1333–1337, 1976

    Article  PubMed  Google Scholar 

  6. Raizner AE, Chahine RA, Ishimori T, Verani MS, Zacca N, Jamal N, Miller RR, Luchi RJ: Provocation of coronary artery spasm by the cold pressor test. Hemodynamic, artériographie and quantitative angiographic observations. Circulation 62: 925–932, 1980.

    PubMed  CAS  Google Scholar 

  7. Rasmussen K, Bagger JP, Bottzauw J, Henningsen P: Prevalence of vasospastic ischaemia induced by the cold pressor test or hyperventilation in patients with severe angina. Eur Heart J 5: 354–361, 1984.

    PubMed  CAS  Google Scholar 

  8. Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LSC, McGoon DC, Murphy ML, Roe BB: A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51: 7–40, 1975

    Google Scholar 

  9. Chahine RA: Prinzmetal’s variant angina. A syndrome apart or another clinical presentation of atheromatous heart disease. Arch Intern Med 139: 26–27, 1979

    Article  PubMed  CAS  Google Scholar 

  10. Maseri A, Severi S, de Nes M, l’Abbate A, Chierchia S, Marzilli M, Ballestra AM, Parodi O, Biagini A, Distante A: ‘Variant’ angina: one aspect of a continuous spectrum of vasospastic myocardial ischemia. Pathogenetic mechanisms, estimated incidence and clinical and coronary arteriographic findings in 138 patients. Am J Card 42: 1019–1035, 1978

    Article  PubMed  CAS  Google Scholar 

  11. Maseri A, l’Abbate A, Chierehia S, Parodi 0, Severi S, Biagini A, Distante A, Marzilli M, Ballestra AM: Significance of spasm in the pathogenesis of ischemic heart disease. Am J Card 44: 788–792, 1979

    Article  PubMed  CAS  Google Scholar 

  12. Oliva PB, Breckinridge JC: Arteriographic evidence of coronary arterial spasm in acute myocardial infarction. Circulation 56: 366–374, 1977

    PubMed  CAS  Google Scholar 

  13. Maseri A, l’Abbate A, Baroldi G, Chierehia S, Marzilli M, Ballestra AM, Severi S, Parodi O, Biagini A, Distante A, Pesola A: Coronary vasospasm as a possible cause of myocardial infarction. A conclusion derived from the study of ‘preinfarction’ angina. N Engl J Med 299: 1271–1277, 1978

    Article  PubMed  CAS  Google Scholar 

  14. Bertrand ME, LaBlanche JM, Tilmant PY, Thieuleux FA, Delforge MR, Carre AG, Asseman P, Berzin B, Libersa C, Laurent JM: Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography. Circulation 65: 1299–1306, 1982

    Article  PubMed  CAS  Google Scholar 

  15. Bauman D: Complications after provocation of coronary spasm with ergonovine maleate. Am J Cardiol 42: 694–695, 1978

    Article  PubMed  CAS  Google Scholar 

  16. Kelley KO, Feigl EO: Segmental a-receptor-mediated vasoconstriction in the canine coronary circulation. Circ Res 43: 908–917, 1978

    PubMed  CAS  Google Scholar 

  17. Feldman RL, Curry RC Jr, Pepine CJ, Mehta J, Conti CR: Regional coronary hemodynamic effects of ergonovine in patients with and without variant angina. Circulation 62: 149–159, 1980

    PubMed  CAS  Google Scholar 

  18. Feldman RL, Whittle JL, Marx JD, Pepine CJ, Conti CR: Regional coronary hemodynamic responses to cold stimulation in patients without variant angina. Am J Cardiol 49: 665–673, 1982

    Article  PubMed  CAS  Google Scholar 

  19. Guiomard A, Zygelman M, Evstigneff T, Bréaud N, Roland E, Pansard Y, Mérillon JP, Gourgon R: Effets hémodynamiques et métaboliques coronaires du test au froid avant et après acébutolol. Arch Mal Coeur 76: 77–85, 1983

    PubMed  Google Scholar 

  20. Feldman RL, Whittle JL, Pepine CJ, Conti CR: Regional coronary angiographic observations during cold stimulation in patients with exertional chest pain: Comparison of diameter responses in normal and fixed stenotic vessels. Am Heart J 102: 822–830, 1981

    Article  PubMed  CAS  Google Scholar 

  21. Wendt Th, Schutz W, Kaltenbach M, Kober G: Auswirkung von Kältereizen auf Hämodynamik und Koronargefässweite. Provokation von Koronarspasmen. Z Kardiol 72: 24–31, 1983

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology (Chief: P.G. Hugenholtz, M.D., F.A.C.C.) Thoraxcenter, Erasmus University, and University Hospital Dijkzigt, Rotterdam, The Netherlands

    J. H. C. Reiber Ph.D., P. W. Serruys M.D. & C. J. Slager M.Sc.

Authors
  1. J. H. C. Reiber Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. W. Serruys M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. J. Slager M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1986 Martinus Nijhoff Publisher, Dordrecht

About this chapter

Cite this chapter

Reiber, J.H.C., Serruys, P.W., Slager, C.J. (1986). Responses of normal and obstructed coronary arterial segments to cold stimulation; a quantitative angiographic study. In: Quantitative Coronary and Left Ventricular Cineangiography. Developments in Cardiovascular Medicine, vol 51. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4239-4_20

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-4239-4_20

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8382-9

  • Online ISBN: 978-94-009-4239-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation