G. Drobinski et al., CORONARY-ARTERY VASOMOTION IN CARDIAC TRANSPLANT PATIENTS WITH NORMALCORONARY ANGIOGRAMS, International journal of cardiology, 40(2), 1993, pp. 155-160
In 18 consecutive transplant patients with normal coronary angiograms
and without calcium blocker therapy, and in 20 controls, we measured t
he diameters of the left anterior descending artery using quantitative
coronary angiography. Measurements were effected on the frames record
ed 5 min or more after intravenous administration of 0.4 mg methylergo
metrine, and 2 min after subsequent 2 mg bolus intracoronary isosorbid
e dinitrate administration. The arterial vasodilatory capacity was def
ined as the ratio of the difference of the largest and smallest arteri
al diameters and the smallest diameter. We observed normal vasoconstri
ction of the different coronary arterial segments. Coronary arterial d
iameter decrease from basal state was about 8% and was more pronounced
at the distal segments of the left anterior descending artery. There
was no difference of vasodilatory capacity between transplant patients
and controls for the proximal and middle portion of the left anterior
descending artery, while the difference was highly significant for th
e distal portion. In eight patients, the decrease of the vasodilatory
capacity was beyond the lower limit of the normal range of values. The
significance of those quantitative angiographic abnormalities is stil
l unproven. They could be due to early vasomotor capacity blunting aft
er transplantation and to late structural alterations of distal corona
ry vessels in cardiac transplant patients.