Chest
Clinical InvestigationsCARDIOLOGYThe Preventive Effect of Magnesium on Coronary Spasm in Patients With Vasospastic Angina
Section snippets
Study Subjects
We studied 22 Japanese patients with VSA (mean age, 57 years; range, 43 to 69 years; 19 men, 3 women) who fulfilled the followinginclusion criteria: (1) spontaneous chest pain associated with, ST-segment elevation or depression on 12-lead ECG or ambulatory ECG atrest; (2) coronary spasm (≥ 50% reduction of the diameter of theartery during coronary angiography) in the left coronary artery (LCA)associated with ST-segment changes and/or typical chest pain afterintracoronary injection of Ach; and
Clinical Characteristics
The clinical characteristics of the studied patients are listed inTable 1. No significant differences in the clinical characteristics existedbetween the Mg and control groups.
In the Mg group, coronary spasm was induced in seven patients byintracoronary Ach infusion at a dose of 30 μg/min, and in theremaining seven patients at a dose of 100 μg/min. In the controlgroup, coronary spasm was induced in five patients at a dose of 30μg/min, and in the remaining three patients at a dose of 100μg/min.
Discussion
The present study demonstrates that Mg infusion reduces, Ach-induced coronary spasm, improving not only chest symptoms and, ST-segment shift but also QCA findings in the majority of patients with, VSA. Coronary angiography confirms that Mg infusion dilates thecoronary arteries at baseline and attenuates the vasoconstriction inthe spastic segments of the coronary arteries in response to Ach.
Conclusion
Mg infusion causes nonsite-specific dilation of the coronaryarteries and suppresses Ach-induced coronary spasm inpatients with VSA. These findings suggest that IV Mg infusion may havetherapeutic application in modulating the increased coronary tonus inpatients with ischemic heart disease associated with coronary spasm. Furthermore, these results suggest that long-term oral Mgsupplementation might prevent or reduce coronary spasm in patients with, VSA.
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