CORONARY VASOMOTOR FUNCTION IN A NORMOTENSIVE, NONDIABETIC REFERRAL POPULATION WITH NORMAL CORONARY ARTERIOGRAMS

Coronary vasomotor function, defined as potential for vasorelaxation a nd augmentation of coronary blood flow, is adversely affected by multi ple factors, including increased age, systemic hypertension, left vent ricular hypertrophy, hyperlipidemia, atherosclerosis, estrogen deficie ncy, diabetes mellitus, and longterm use of tobacco.(1-7) Pathophysiol ogy of acute coronary syndromes, vasospastic angina, and progression o f atherosclerosis all appear to be linked to coronary endothelial dysf unction and depressed capacity for coronary relaxation.(8-10) The purp ose of this study was to define the reference range for pharmacologica lly induced coronary vasodilation in a healthy referral cardiac popula tion composed of normotensive, nondiabetic subjects with normal corona ry arteriograms that showed no angiographic evidence of atherosclerosi s. This population is hereafter referred to as referral normal. Intrac oronary Doppler measurements of coronary blood flow velocity and quant itative coronary angiography were used to study 3 indicators of corona ry vasomotor function: endothelium-dependent vasodilator response to i ntracoronary acetylcholine, endothelium-independent vasodilator respon se to intracoronary adenosine, and endothelium-independent vasodilator response to intracoronary nitroglycerin.