J Cardiol 2006 Dec; 48 6 : Clinical Report : Survey of Coronary Spasm in Japan Before the Establishment of Spasm Guideline: Analysis of Questi

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1 Clinical Report : Survey of Coronary Spasm in Japan Before the Establishment of Spasm Guideline: Analysis of Questionnaires in All Japan Shozo Akira Yousuke Hiroaki Hiroshi SUEDA, MD,FJCC OSHITA, MD IZOE, MD KOHNO, MD FUKUDA, MD Key Words Coronary vasospasm guideline, Japan Angina pectoris , % 208/1, % 12/6923.1% 18/7820.3% : Department of Cardiology, Saiseikai Saijo Hospital, Ehime Address for correspondence : SUEDA S, MD, FJCC, Department of Cardiology, Saiseikai Saijo Hospital, Tsuitachi 269 1, Saijo, Ehime ; EZF03146@nifty.com Manuscript received June 13, 2006; revised July 22, 2006; accepted August 16,

2 334 57/ % 12/ % 17/ % 34/ % 30/ % 28/ % 28% 2% 0% Dose of ACh in the RCAg 20// 80 20/ 10/20 30 / 25/ 20// /25/ 20// 80/100 5/15/ 20/ 5/10/20/ 20/ 10/20 10/20/ Table 1 Dose of acetylcholine Dose of ACh in the LCAg 20//100 / /20// // / // /25// / /100/ 1 10/30/100 5/10/20//100 30/60/100 20/30/ /60 Number % ACh acetylcholine ; R L CA right left coronary artery. 2 47% 27% 19% 3 53% 15% 8% 4 44% 23% 14% 9% 2% Table 2 Administration time of acetylcholine Administration time Number % 10 sec sec sec sec 180 sec 5 62% 16% 13% 6 Tables 1, 2 7 Tables 3, 4 J Cardiol 2006 Dec; 48 6 :

3 335 Dose of ER in the RCAg 20/ 20 1/5 /10/20/ 30/40 20/ / /15 30/ 15/25 10/30/ 4/8/16 2.5/10 25/ / Table 4 Administration time of ergonovine Administration time Table 3 Dose of ergonovine Dose of ER in the LCAg 20/ 20 1/5 /10/20/ 30/40 20/40/ 60/ // /15/ 30/ 10/20/30 10/30/ 6/12/24 5/15/30 / /20 80 ER ergonovine. Other abbreviations as in Table 1. Number % Number % 8 44% 39% 9 Fig % 24% 10% 11 37% 36% 12 Fig % 29% 14% Fig. 1 Complications of acetylcholine spasm provocation tests VF ventricular fibrillation ; VT ventricular tachycardia; AMI acute myocardial infarction ; TIA transient ischemic attack; EMD electromechanical dissociation.

4 336 Fig. 2 Complications of ergonovine spasm provocation tests C AV block complete atrioventricular block ; Res respirator ; IABP intraaortic balloon pumping. Other abbreviations as in Fig % 90% 25% 12% 75% 15 16% 90% 14% 14% 75% 18 69% 48% 46% 75% 14% 75% 19 Fig % 28% 10% 8% 17 52% 32% 6% 3% % 21% 1% % 52% 2 42% J Cardiol 2006 Dec; 48 6 :

5 % 36% 24 Fig. 4 H % 44% 10% 9% 7% 1% Fig. 3 Definition of positive spasm in each hospital AHA American Heart Association; CAG coronary angiography ; EDP end-diastolic pressure ; LVG left ventriculography ; GERD gastroesophageal reflux disease ; CS coronary sinus. Other abbreviation as in Table % 30% 1% 27% % 36% 30% 27 70% 21% 2% 28

6 338 Fig. 4 Efficacy of drugs in patients with refractory coronary spastic angina Ca calcium; ACE-I angiotensin converting enzyme inhibitor; ARB angiotensin receptor blocker; Mg magnesium. 76% 33% 15% 2% % 20% 14% 30 46% 37% 26% Treadmill 24% 6% 31 31% 28% 16% 21% BMIPP 13% MIBG 8% Tl 1% MIBI % 32% 23% 33 73% 18% 5% J Cardiol 2006 Dec; 48 6 :

7 % 16% 14% 35 55% 40% 100% 0% 41 74% 14% 8% 36 35% 13% Statin 8% Intervention 7% ACE-I/ARB % 38% 1% 38 43% 26% 23% 39 51% 21% 14% 3% 2% Fig Fig. 5 Comments of questionnaire of coronary spasm DC direct-current countershock ; PCPS percutaneous cardiopulmonary support ; DCM dilated cardiomyopathy ; HCM hypertrophic cardiomyopathy ; HHD hypertensive heart disease. Other abbreviations as in Fig. 2.

8 340 17, Tables 1, 2 Tables 3, 4 2/3 Figs. 1, 2 71% 76% 4 46% 2 99% 25% 90% 32% 75% 12% 99% 14% 90% 16% 75% 14% 49% Fig % Fig. 4 53% 44% 9% 5 73% 42% 23% 2 38% 19 55% 35% 20, % 51% 37% 74% J Cardiol 2006 Dec; 48 6 :

9 341 8% 14% Fig % : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : JA

10 342 : : : : : KKR : : : : : : : :: : , % 74% 80% J Cardiol 2006 Dec; 48 6 : Circ J 2002 ; 66 Suppl : Jpn Circ J 2000; 64 Suppl: Jpn Circ J 2000 ; 64 Suppl: Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, Mark DB, Marwick TH, McCallister BD, Thompson PD Jr, Winters WL, Yanowitz FG, Ritchie JL, Gibbons RJ, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Lewis RP, O Rourke RA, Ryan TJ : ACC/AHA Guidelines for Exercise Testing : A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Committee on Exercise Testing. J Am Coll Cardiol 1997; 30 : Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS Ferguson TB Jr, Fihn SD, Fraker TD Jr, Gardin JM, O Rourke RA, Pasternak RC, Williams SV, Gibbons RJ, Alpert JS, Antman EM, Hiratzka LF, Fuster V, Faxon DP, Gregoratos G, Jacobs AK, Smith SC Jr ; American College of Cardiology ; American Heart Association Task Force on Practice Guidelines. Committee on the Management of Patients With Chronic Stable Angina: ACC/AHA 2002 guideline update for the management of patients with chronic stable angina : Summary article : A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Committee on the Management of Patients With Chronic Stable Angina. Circulation 2003 ; 107 : J Cardiol 2006 Dec; 48 6 :

11 Antman EM, Anbe DT, Armstrong PW, Bates ER, Green La, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK ; American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction : ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction : Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction. Circulation 2004 ; 110: Sueda S, Ochi N, Kawada H, Matsuda S, Hayashi Y, Tsuruoka T, Uraoka T: Frequency of provoked coronary vasospasm in patients undergoing coronary arteriography with spasm provocation test of acetylcholine. Am J Cardiol 1999; 83 : Sueda S, Kohno H, Fukuda H, Ochi N, Kawada H, Hayashi Y, Uraoka T : Frequency of provoked coronary spasms in patients undergoing coronary arteriography using a spasm provocation test via intracoroanry administration of ergonovine. Angiology 2004; 55 : Pristipino C, Beltrame JF, Finocchiaro ML, Hattori R, Fujita M, Mongiardo R, Cianflone D, Sanna T, Sasayama S, Maseri A: Major racial differences in coronary constrictor response between Japanese and caucasians with recent myocardial infraction. Circulation 2000; 101: Beltrame JF, Sasayama S, Maseri A: Racial heterogeneity in coronary artery vasomotor reactivity : Differences between Japanese and Caucasian patients. J Am Coll Cardiol 1999; 33 : : : 2004; 23: : :. 2004; 23: : : J Jpn Coron Assoc 2004; 10 : : : 2005 ; 37: Sueda S, Izoe Y, Kohno H, Fukuda H, Uraoka T : Need for documentation of guidelines for coronary artery spasm : An investigation by questionnaire in Japan. Circ J 2005; 69: Yasue H, Horio Y, Nakamura N, Fujii H, Imoto N, Sonoda R, Kugiyama K, Obata K, Yoshimura M, Kimura T : Induction of coronary artery spasm by acetylcholine in patients with variant angina : Possible role of the parasympathetic nervous system in the pathogenesis of coronary artery spasm. Circulation 1986; 74 : Sueda S, Saeki H, Otani T, Mineoi K, Kondou T, Yano K, Ochi T, Ochi N, Hayashi Y, Tsuruoka T, Kawada H, Matsuda S, Uraoka T : Major complications during spasm provocation tests with an intracoronary injection of acetylcholine. Am J Cardiol 2000 ; 85 : Sueda S, Fukuda H, Watanabe K, Ochi N, Kawada H, Hayashi Y, Uraoka T: Clinical characteristics and possible mechanism of paraoxysmal atrial fibrillation induced by intracoronary injection of acetylcholine. Am J Cardiol 2001; 88 : Sueda S, Kohno H, Fukuda H, Watanabe K, Ochi N, Kawada H, Uraoka T : Limitations of medical therapy in patients with pure coronary spastic angina. Chest 2003 ; 123: Gersh BJ, Braunwald E, Bonow RO : Chronic coronary artery disease. in Heart Disease : A Textbook of Cardiovascular Medicine ed by Braunwald E, Zipes DP, Libby P 6th Ed. WB Saunders, Philadelphia, 2001; p Sueda S, Kohno H, Fukuda H, Uraoka T : Did the widespread use of long-acting calcium antagonists decrease the occurrence of variant angina? Chest 2003 ; 124 : : : Jpn J Interv Cardiol 2006; 21 :47 54

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21-07_後藤論文.smd 2015; 21: 5866 Yoichi Goto: Current status and future perspective of cardiac rehabilitation in Japan. J Jpn Coron Assoc 2015; 21: 5866 I 1 1 3 1 2 3 QOL 2 Fig. 1 1 196070 AMI AMI 1980 AMI CABG comprehensive