CORONARY BLOOD-FLOW DYNAMICS DURING TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION FOR STABLE ANGINA-PECTORIS ASSOCIATED WITH SEVERE NARROWINGOF ONE MAJOR CORONARY-ARTERY

To study the effect of transcutaneous electrical nerve stimulation (TE NS) on coronary vasomotion, patients with New York Heart Association c lass III angina pectoris and significant single-vessel left coronary a rtery disease and who were also scheduled for elective percutaneous tr ansluminal coronary angioplasty, were allocated to a study group (prec ordial actual TENS, n = 10) and a control group (precordial simulated TENS, n = 5, and TENS on the back, n = 3). Coronary volumetric flow wa s assessed in the stenotic and nonstenotic coronary artery before and after neurostimulation. The diameter tin millimeters) of the stenotic coronary artery was reduced in the study group after actual TENS (from 2.73 +/- 0.55 by 0.12 +/- 0.11; p = 0.008). In the nonstenotic corona ry artery, the diameter increased in the study group (from 2.64 +/- 0. 43 by 0.24 +/- 0.15; p = 0.01). In both the stenotic and nonstenotic c oronary arteries, no effect was shown on the average peak velocity (ce ntimeters per second) in the study group. The coronary volumetric flow (milliliters per minute) was reduced in the stenotic artery of the st udy group (from 62 +/- 18 by 8 +/- 7; p = 0.007). In the nonstenotic c oronary artery, volumetric flow increased in the study group (from 57 +/- 18 by 11 +/- 10; p = 0.007). In the control group, simulated TENS and TENS on the back had no effect on the diameter of the artery, aver age peak velocity, or volumetric flow. In addition, in all patients, T ENS had no effect on the total volumetric flow of the left coronary ar tery and hemodynamic variables during the study period. This observati on suggests that TENS modulates regional coronary vasomotion in patien ts with coronary artery disease. (C) 1998 by Excerpta Medico, Inc.