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Paradoxical Vasoconstriction Induced by Acetylcholine in Atherosclerotic Coronary Arteries by Paul L. Ludmer; Andrew P. Selwyn; Thomas L. Shook; Richard R. Wayne; Gilbert H. Mudge; R. Wayne Alexander; Peter Ganz is a Medicine article available to read on EtoBox.

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Acetylcholine is believed to dilate normal blood vessels by promoting the release of a vasorelaxant substance from the endothelium (endothelium-derived relaxing factor). By contrast, if the endothelium is removed experimentally, acetylcholine constricts blood vessels. We tested the hypothesis that muscarinic cholinergic vasodilation is impaired in coronary atherosclerosis. Graded concentrations of acetylcholine and, for comparison, the nonendothelial-dependent vasodilator nitroglycerin were infused into the left anterior descending artery of eight patients with advanced coronary stenoses (greater than 50 percent narrowing), four subjects with angiographically normal coronary arteries, and six patients with mild coronary atherosclerosis (less than 20 percent narrowing). Vascular responses were evaluated by quantitative angiography. In several segments each of four normal coronary arteries, acetylcholine caused a dose-dependent dilation from a control diameter of 1.94 +/- 0.16 mm to 2.16 +/- 0.15 mm with the maximal acetylcholine dose (P less than 0.01). In contrast, all eight of the arteries with advanced stenoses showed dose-dependent constriction, from 1.05 +/- 0.05 to 0.32 +/- 0.

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Author

Paul L. Ludmer; Andrew P. Selwyn; Thomas L. Shook; Richard R. Wayne; Gilbert H. Mudge; R. Wayne Alexander; Peter Ganz

Published

1986

Language

EN

Field

Medicine (Health Sciences)