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Biomedical subjects

F Cherrier

Publications and source records attributed to F Cherrier.

At least 127 records · Page 7Linked to original sources
PubMed1985

Prophylactic effect of intravenous tiapamil on methylergometrine-induced coronary artery spasm in patients with variant angina: randomized double-blind trial.

Tiapamil is a new calcium entry blocker. The ability of its intravenous form to prevent methylergometrine-induced coronary artery spasm was studied in 11 consecutive patients with angiographically documented vasospastic angina. The study was designed as a double-blind crossover trial of tiapamil vs placebo. Each patient received, in a randomized order, either tiapamil, as a 1.5 mg/kg intravenous bolus followed by a 50 micrograms/kg/min infusion lasting 3 hours, or a matched placebo. Immediately after the infusion, methylergometrine tests were performed with up to 0.4 mg of methylergometrine or until a positive ECG was recorded. Compared to the values obtained after placebo infusion, tiapamil significantly lowered systolic and diastolic blood pressure (respective pre- and posttiapamil values: 119.9 +/- 17.7 vs 142.1 +/- 25.5 mm Hg, p less than 0.01; and 72.0 +/- 9.1 vs 82.4 +/- 9.3 mm Hg, p less than 0.02); the drug exerted no significant effect on heart rate (63.9 +/- 13.3 vs 67.6 +/- 16.5 bpm, NS), PR interval (0.180 +/- 0.020 vs 0.177 +/- 0.017 sec NS), or QTc interval (404.4 +/- 16.5 vs 396.0 +/- 26.6 msec, NS). After placebo, 10 patients had positive methylergometrine tests following single doses ranging from 0.1 to 0.4 mg. The remaining patient developed ventricular bigeminy, which resolved immediately after administration of isosorbide dinitrate; his test was therefore considered negative in the evaluation of the results. In contrast, after tiapamil, eight patients had negative tests for doses of up to 0.4 mg methylergometrine, and three had positive tests for the same methylergometrine doses as after the placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Proarrhythmic and antiarrhythmic effects of intravenous prostacyclin in man.

Prostacyclin (PGI2) has been shown to reduce the occurrence of experimental ventricular arrhythmias. To assess potential beneficial effects in man, the electrophysiological action of PGI2 was studied in 16 non medicated patients. The protocol used in incremental pacing and programmed stimulation in the right atrium and ventricle. This protocol and measurement of effective refractory periods (ERP) were performed before and during the injection of 2.5, 5 and 10 ng kg-1 min-1 of PGI2. The atrial functional refractory period decreased significantly (P less than 0.05); PGI2 had no influence on the occurrence of inducible non-sustained (NS) atrial tachycardias and was responsible for the occurrence of 2 non-sustained atrial tachycardias in 8 patients with inducible atrial echo beats under basal conditions. Thirteen patients did not have inducible ventricular tachycardia (VT) under basal conditions. Non-sustained VT was induced after PGI2 in 4 of them but in only 1 of them after the administration of propranolol. Three patients had inducible VT under basal conditions (1 non-sustained, 2 sustained VT). PGI2 did not prevent the occurrence of VT (1 non-sustained, 1 sustained VT), except in 1 patient with ischaemic-related VT, who had non-sustained VT after PGI2. In conclusion, PGI2 does not seem to have a cardiac antiarrhythmic effect and may increase the atrial and ventricular repetitive response. This effect could be related to an increase of adrenergic tone.

Adult↗
PubMed1985

[Long-term effects of transluminal coronary angioplasty. French multicenter study].

Although transluminal coronary angioplasty is now acknowledged as an effective treatment for coronary artery disease, the long-term outcome of patients treated by this method is still under evaluation. A french multicenter trial was set up and the long-term efficacy of transluminal coronary angioplasty was assessed in 546 patients undergoing the procedure before the 31/3/83. 380 initial successes (69 p. 100) were followed up for a period ranging from 6 to 48 months (average 19.9 +/- 10.4 months). A control coronary angiography was carried out in 88 p. 100 of cases. Restenosis (loss of over 50 p. 100 of initial angiographic improvement) was observed in 27 p. 100 of cases. Including the repeat procedures, the patency rate of the dilated vessels was 82 p. 100. Progression of atherosclerosis on another coronary artery was observed in 1.3 p. 100 of cases. After transluminal coronary angioplasty, 72 p. 100 of patients remained improved, 11 p. 100 underwent repeat angioplasty, 8 p. 100 underwent coronary bypass surgery, 1.3 p. 100 suffered myocardial infarction and 1.3 p. 100 died. Restenosis was associated with recurrence of angina pectoris in 90 p. 100 of cases (within 3.3 +/- 1.6 months) and a positive exercise stress test in 87 p. 100 of cases. Recurrence of angina due to progression of disease on the dilated vessel was observed in 24.2 p. 100 of cases; repeat transluminal coronary angioplasty was carried out for this indication in 38 p. 100 of cases, coronary bypass in 34.8 p. 100 and medical treatment was continued in 27.2 p. 100 of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1985

[Complications of transluminal coronary angioplasty. A multicenter French study (1983)].

The authors report the complications observed during 1 247 transluminal coronary angioplasties (TCA) performed in 1 187 patients in 17 french centers between 1979 and October 1983. There were 855 primary successes (68.9 p. 100). There were 41 cases of symptomatic dissection (3.3 p. 100) of which 32 underwent aortocoronary bypass surgery with a residual myocardial infarction (MI) in 13 cases (40.6 p. 100). Medical treatment of symptomatic dissection gave very poor results (7 out of 9 MI) and is formally contra-indicated. 67 per- or postoperative occlusions were observed (5.3 p. 100). This is the most serious complication which necessitates an emergency revascularisation procedure (TCA or coronary bypass surgery--CBS--) because MI rapidly follows in patients without a well-developed collateral circulation. In this series MI occurred in 28 out of 45 patients--62 p. 100--despite CBS. This underlines the value of an immediate repeat TCA which, when successful, results in a much faster revascularisation. Seventy-three MI (5.8 p. 100) were observed in the first 24 hours: 50 p. 100 were secondary to an angiographically documented coronary occlusion. The other two causes were coronary dissection and spasm. Emergency CBS was carried out in 107 cases (8.9 p. 100) mainly for coronary occlusion or symptomatic dissection. The mortality was 11 out of 1 187 patients (0.93 p. 100). Death occurred in the catheter laboratory in 3 cases, during the first 24 hours in the operating theatre in 1 case, and after the first 24 hours but before hospital discharge in 7 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗
PubMed1985

[Exertion isotope tests in coronary insufficiency. Comparison with isotopic ventriculography and myocardial scintigraphy].

Very few studies have been described comparing the value of exercise myocardial scintigraphy and left ventricular angioscintigraphy. The authors designed a study comparing these two investigations with conventional exercise stress testing and coronary angiography. The isotopic investigations were carried out within 48 hours of coronary angiography. A total of 143 patients undergoing coronary angiography (35 normal, 108 coronary patients: 36 single vessel, 36 double vessel and 36 triple vessel disease) were included in this study. The lesions were located of the LAD (77 cases), left circumflex (77 cases) and right coronary arteries (62). The sensitivity and specificity of both radionuclide investigations were evaluated to assess their diagnostic value; the best results were obtained with myocardial scintigraphy (sensitivity 86 p. 100; specificity 100 p. 100); angioscintigraphy had a sensitivity of 71 p. 100 and specificity of 97 p. 100, and conventional exercise stress testing of 42 p. 100 and 70 p. 100 respectively. The sensitivity seemed to increase with the degree of stenosis; although the sensitivity of myocardial scintigraphy increased progressively, that of angioscintigraphy doubled in cases of stenosis 90 p. 100 (stenosis less than 90 p. 100, sensitivity = 37 p. 100; stenosis greater than 90 p. 100, sensitivity = 73 p. 100). The sensitivity of myocardial scintigraphy with respect to the severity of the coronary artery disease was best in cases of right coronary artery stenosis (sensitivity in cases of RCA stenosis = 74 p. 100; sensitivity in LAD stenosis = 58 p. 100; sensitivity in left circumflex stenosis = 43 p. 100). The sensitivity of left ventricular angioscintigraphy was best in LAD stenosis (RCA stenosis = 50 p. 100, LAD stenosis = 64 p. 100, left circumflex stenosis = 36 p. 100). The sensitivity of both investigations was poor in left circumflex artery stenosis even when severely diseased. The sensitivity of both investigations was better in diffuse coronary artery disease: myocardial scintigraphy (single vessel disease: 72 p. 100, double vessel disease: 92 p. 100, triple vessel disease: 94 p. 100), left ventricular angioscintigraphy (61 p. 100, 69 p. 100, and 83 p. 100 respectively). Although the association of these two radioisotopic investigations does not improve diagnostic sensitivity, it does provide more information about the localisation and extension of the coronary artery disease especially in LAD and right coronary artery stenosis. These results suggest that these investigations are complementary in the evaluation of patients with coronary artery disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Coronary Disease↗
PubMed1985

[Biventricular thrombosis in nephrotic syndrome with hypercoagulability and hypereosinophilia].

A case of double right and left intraventricular thrombosis diagnosed by 2D echocardiography is reported in a 20 year old man with nephrotic syndrome with eosinophilia and hypercoagulability, admitted as an emergency for a staphylococcal septicaemia in shock and anuria. Anticoagulation with heparin did not prevent two episodes of pulmonary embolism. Complete dissolution of the thrombi was obtained by peripheral administration of fibrinolytic therapy (urokinase and plasminogen). The authors discuss the differential diagnosis of echocardiographic appearances of biventricular masses and possible causes of these thrombi are suggested.

Adult↗
PubMed1985

[Diagnostic value of methods of ventricular and auricular stimulation in the evaluation of tachycardia].

The diagnostic value of programmed pacing in the investigation of tachycardia (greater than 5 premature complexes) was studied in 155 patients admitted for evaluation of dizzy attacks and/or tachycardia by determining a relationship between the induction of tachycardia by endocavitary pacing and the presence of spontaneous attacks on ECG and/or 24 hour Holter monitoring. Right atrial and ventricular programmed pacing comprised: an extrastimulus during sinus rhythm (method I), during paced rhythm (method II), 2 extrastimuli during sinus rhythm (method III) and paced rhythm (method IV). The protocol was applied in 20 cases of spontaneous atrial tachycardia (AT) and 40 patients without tachycardia, and in 20 cases of spontaneous sustained ventricular tachycardia (VTS) (Group A), 15 cases of non-sustained ventricular tachycardia (VTNS) (Group B), 20 cases of ventricular doublets or triplets on Holter monitoring (Group C) and 40 patients without ventricular arrhythmias. The following results were obtained: At atrial level, method I was associated with a 75% sensitivity and a 62.5 p. 100 specificity when the triggering of atrial echos was considered. It was difficult to induce AT with methods I, II and III (sensitivity 15, 20 and 45 p. 100 - but they were very specific (greater than 90 p. 100). The induction of echos with methods II, III and IV was very sensitive but not specific and could not be retained as a pathological criterion. Using method IV, only the triggering of sustained AT could be considered to have a good specificity (90 p. 100), but sensitivity remained low (30 p. 100). At ventricular level, more aggressive methods were needed to induce an arrhythmia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Spasm in a single coronary artery].

A 52 year old man presented with effort and resting angina with positive exercise stress testing and myocardial scintigraphy. The initial coronary angiogram showed a single coronary vessel arising from the right coronary ostium dividing into a right coronary artery with a normal trajectory lined with a few non stenotic atheromatous plaques and a left coronary artery which passed between the aorta and pulmonary artery to reach the left atrioventricular groove. At first, it was suggested that the angina was due to compression of the left coronary vessel by the great arteries during effort, but this mechanism could not explain attacks of resting angina and the failure of betablocker therapy. An ergometrine test performed during repeat coronary angiography induced almost complete occlusion of the right coronary vessel and Prinzmetal diaphragmatic ischaemia. The anginal attacks were completely suppressed by Calcium antagonist drugs. The association of coronary spasm and a single coronary artery is rare; only one case has been previously reported. We do not believe that there was a relationship between the two phenomena in our case: the spasm occurred at a distance from the aberrant course of the vessel. The authors emphasise the diagnostic problems and the potential danger of this association.

Coronary Vasospasm↗
PubMed1985

[Mitral valve prolapse. Results of electrophysiological studies].

Classically, the frequency of latent left-sided Kent bundles and ventricular tachycardia (VT) is increased in mitral valve prolapse (MVP). To verify this hypothesis, 23 patients with clinical and echocardiographic (M mode and 2D) signs of MVP underwent electrophysiological studies for dizziness or syncope (12 cases) or palpitations (11 cases). In addition to the standard electrophysiological studies, analysis of sinoatrial and atrioventricular conduction, they underwent programmed ventricular pacing (St V2): coupled and then paired St V2 in sinus rhythm and during ventricular pacing (100-150/min) under basal conditions (15 patients), after injection of 2 mg Atropine (6 patients), and 10 micrograms of Isoproterenol (4 patients). These manoeuvres showed that symptoms of dizziness were due to increased vagal tone in 6 cases (associated with paroxysmal nodal tachycardia--PNT--in 3 cases), to sinoatrial block in 2 cases (associated with atrial tachycardia in 1 case), to suprahisian conduction defects in 3 cases (associated with atrial tachycardia in 1 case) and to VT in 1 case. Palpitations were due to VT in 1 case, atrial tachycardia in 1 case and PNT in 9 cases. Our analysis showed a high incidence of PNT (10 cases) with normal inter critical ECG. These arrhythmias were due to intranodal reentry in 7 cases (70%), to a latent left-sided Kent bundle in 2 cases and to a paraseptal Kent bundle in 1 case. These PNT were characterised by induction during exercise (6 cases) and by their association with flutter-type reentry (5 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Cardiac electrophysiologic effects of prostacyclin in man].

The electrophysiological effects of prostacyclin (PGI2) at increasing doses (2.5, 5 and 10 ng/kg/min) were assessed in 16 patients during classical investigations of sinus node function and atrioventricular conduction and during programmed atrial and right ventricular under basal conditions and during prostacyclin perfusion. Ten patients had normal sinus node function and atrioventricular conduction under basal conditions. Stastistically significant changes were observed during PGI2 perfusion: shortening of the sinus cycle length (p 0.01), decreased intraatrial conduction time (p less than 0.05), reduced atrial functional refractory period (p less than 0.01) and reduced effective and functional refractory periods of the AV node (p less than 0.05), increased anterograde (p less than 0.01) and retrograde (p less than 0.05) Wenckebach point. The changes were dose dependent. No significant changes were observed in sinus node recovery periods of the His Purkinje system. Similar changes were recorded on 4 other patients with various conduction defects. Paired atrial stimulation induced manifestations of hyperexcitability in 5 patients. In 2 patients with normal responses under basal conditions it was possible to induce non-sustained atrial tachycardia during PGI2 administration. In 3 patients with inducible atrial tachycardia under basal conditions, it was still possible to induce the tachycardia after PGI2 but this disappeared in all but one patient with the sick sinus syndrome after the addition of propranolol. The changes in ventricular excitability were studied by a specific protocol in 16 patients. Of the 13 patients without inducible ventricular tachycardia under basal conditions, 4 developed inducible non-sustained ventricular tachycardia after PGI2. Three patients had inducible VT under basal conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Sudden death in mitral valve prolapse. Apropos of 2 cases].

Two cases of sudden death are reported in patients with mitral valve prolapse with mitral insufficiency. Both had significant impairment of left ventricular function. Irreversible ventricular fibrillation occurred in one patient one-half hour preceding a catheterization, whereas the other patient died during sleep. Review of the literature revealed 42 cases of sudden death in patients with prolapse. Occasionally left ventricular dysfunction or medication overdosage can explain or favor development of the terminal arrhythmia, but usually no precipitating factor other than prolapse can be identified. It appears impossible to identify actual subgroups at risk, although sudden death does occur more frequently in patients with a large amount of prolapse of both valves, previous syncopal episodes, and ECG abnormalities at rest. Complex ventricular arrhythmias are also reported, but their predictive importance is difficult to evaluate. Sudden death is a rare complication of mitral prolapse, fact which should conservatively influence indications for further supplementary testing and treatment in these patients.

Adult↗
PubMed1984

Effects of propranolol and of verapamil on heart rate and blood pressure in hyperthyroidism.

Cardiac manifestations of hyperthyroidism have been attributed to enhanced sympathoadrenal activity, but thyroid hormones also have a direct positive chronotropic effect on sinoatrial cells, in which there are slow calcium channels. We evaluated the effects of verapamil on heart rate, PR and QT intervals, and blood pressure in eight patients with hyperthyroidism and compared them to those effects of propranolol. Three doses of propranolol (0.05, 0.1, and 0.2 mg/kg) and verapamil (0.1, 0.2, and 0.4 mg/kg) were injected intravenously after a 72-hr withdrawal period in a double-blind, crossover fashion. Propranolol increased the RR interval from 581 +/- 51 to 734 +/- 65 msec, whereas verapamil did not have any negative chronotropic effect despite prolonging the PR interval. Systolic blood pressure decreased from 134 +/- 5 to 119 +/- 8 mm Hg after verapamil and was not affected by propranolol. Diastolic blood pressure was depressed equally by both drugs. We conclude that verapamil is not a good alternative drug to propranolol in hyperthyroidism. Our data cannot confirm the possibility of an interaction between thyroid hormones and slow calcium channels in patients with hyperthyroidism.

Adult↗
PubMed1984

Electrophysiological effects of intravenous prostacyclin in man.

The electrophysiological effects of prostacyclin (PGI2) were studied in 10 normal patients. Programmed stimulation was performed before and after infusion of 2.5, 5, 10 ng kg-1 min-1 of PGI2. Then, 0.2 mg kg-1 of propranolol was added to the higher dose of PGI2. We observed a net decrease of the systolic and diastolic arterial blood pressure beginning with the lowest dose. There was no effect on sinus node recovery time, atrial, His-Purkinje and ventricular effective refractory periods, AH and HV intervals. Atrioventricular (AV) nodal effective and functional refractory periods could be measured in 5 patients and were decreased in all cases. Sinus cycle length and anterograde and retrograde Wenckebach cycle lengths were significantly decreased by PGI2 in a dose dependent manner. The injection of propranolol increased all these values but did not suppress entirely the effects of PGI2. In conclusion, the electrophysiological effects of PGI2 were marked decreases of sinus cycle length and AV nodal refractoriness which may be partly related to enhanced sympathetic activity.

Adult↗
PubMed1984

Significance of supraventricular arrhythmias induced by electrophysiologic studies.

The clinical history and the findings on Holter monitoring of 767 patients (without evidence of ventricular pre-excitation on the ECG) were compared with the results of electrophysiological studies to assess the significance of supraventricular arrhythmias induced by intracardiac study. The studies were undertaken to determine the cause of syncope, conduction disturbances or tachycardia. In 570 patients (group 1) supraventricular arrhythmias were not induced. On Holter monitoring, 36 (6%) had evidence of supraventricular tachycardias, including atrial flutter, atrial fibrillation and paroxysmal junctional tachycardia. In 86 patients (group 2) one atrial extrastimulus induced a paroxysmal junctional tachycardia; 79 (82%) of these patients had had spontaneous supraventricular tachycardia (SVT). In 111 patients (group 3) another type of SVT was induced: The movement of the catheter induced atrial flutter or fibrillation in nine patients, eight (89%) of whom had spontaneous SVT. Atrial pacing at a rate less than 200 bpm induced atrial flutter or fibrillation in 14 patients of whom nine (64%) had SVT. Ventricular pacing induced SVT in 15 patients, of whom 14 (64%) had SVT. An atrial extrastimulus during sinus rhythm induced atrial echoes in 62 patients, 47 (76%) of whom had SVT. The atrial extrastimulus during sinus rhythm induced atrial tachycardia in 11 patients, nine (82%) of whom had SVT.

Adolescent↗
PubMed1984

Transient acute ischaemic episodes during or immediately after percutaneous transluminal coronary angioplasty.

Transient ischaemic episodes, defined as chest pain with ST segment elevation resolving in less than 15 min, have been encountered in 18 out of 130 patients during or in the 12h following percutaneous transluminal angioplasty (PTCA). During PTCA, ischaemic episodes occurred in 11 patients (8.5%) along with complete coronary artery occlusion (3 cases), high degree stenosis (6 cases) or no visible angiographic change (2 cases). After PTCA, 7 additional patients (5.3%) had transient ischaemic episodes; 4, within 15 min of the last balloon inflation, corresponding to a high-grade stenosis distal to the site of angioplasty and resolving after intra coronary nitrates; 3 from 45 min to 7h after PTCA, resolving spontaneously or with sublingual nitrates in a few minutes. Several pathophysiological mechanisms may be responsible: catheter induced coronary spasm, coronary artery thrombosis, migration of atheromatous debris from the plaque, bubble emboli, or fall of coronary blood flow. The clinical course is usually benign but repeat angiography and emergency bypass surgery may be necessary if the episodes of ischaemia are recurring or prolonged.

Adult↗
PubMed1984

[Some comments apropos of 120 cases of transluminal coronary angioplasty].

UNLABELLED: Between April 1980 and November 1982, 120 patients underwent transluminal coronary angioplasty (TCA) by Gruntzig's technique (128 attempts on 132 vessels). Immediate results were evaluated by: the transstenotic pressure gradient (disappearance of a systolic gradient, mean residual gradient less than 15 mmHg); angiographic improvement (at least 25 p. 100) with less than 50 p. 100 residual stenosis. Success was confirmed by symptomatic and electrocardiographic improvement, the comparison of radio-isotopic studies (Thallium myocardial scintigraphy or tomography; global and regional left ventricular contractility by Technetium radioangiography) at rest and if possible during exercise before TCA and 2 and 6 months after TCA. The incidence of primary success was 72 p. 100 (stable angina: 67,2 p. 100, unstable angina 79,4 p. 100 NS); recurrence was observed in 16/69 of controlled patients (23,1 p. 100); 7 secondary TCA were performed with 5 successful results, leaving 16 p. 100 "permanent" recurrences in this series. There were 2 deaths (1 electromechanical dissociation, 1 rupture of the balloon with dissection due to dysfunction of a new manometer), 5 rudimentary infarcts (transient Q waves and/or slight enzymatic elevation), 6 infarcts (5 anterior, 1 posterior), 4 acute coronary insufficiencies (total regression after surgery). There were 11 immediate (9 as an emergency) and 9 secondary aorto-coronary bypass operations. There were 2 femoral artery repair procedures. IN CONCLUSION: certain technical procedures are relatively easy; successive utilisation of a 2 then a 3,7 mm balloon in severe or excentric stenoses for instance. Nine stenoses became occluded without infarction between coronary angiography and the TCA procedures: 2 were recanalised by the guide wire (and then dilated). Therefore, in very severe stenoses TCA should be performed rapidly, even straight away. TCA is associated with some risk to the patient: experienced operators and immediate surgical cover are essential. Initial evaluation of results should be careful: measurement of the pressure gradient is often erroneous (damping of pressure wave, transmission of ventricular pressure); automatic measurements show an overestimation of the degree of stenosis of more than 60 p. 100. Stress radioisotopic studies seem to be the most satisfactory way of assessing the outcome. Medium term results are encouraging: the majority of patients return to work, but this took too long. The ideal theoretical indication remains rare.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1984

[Results of coronary transluminal angioplasty following Prinzmetal's angina or fixed stenosis with associated spasm].

Transluminal coronary angioplasty (TCA) was carried out in 130 patients (109 men and 21 women) with an average age of 51 years (range 20 to 76 years) between April 1980 and December 1982. The most commonly affected artery was the LAD (100). All patients were on heparin, coronary vasodilators and calcium antagonists before the procedure, and on calcium antagonists and platelet antiaggregant drugs after TCA. The material and methods used were those described by Gruntzig. In this population, we identified a group of patients, Group I, with fixed stenosis and associated coronary spasm--either Prinzmetal angina (13 cases, 6 of which had both ST-T elevation and other ECG changes) or spontaneous spasm with a variable degree of stenosis (2 cases). The stenosis remained greater than or equal to 70% in all cases after intracoronary injection of nitrate derivatives. There were no differences between this group and that of fixed stenosis (Group II) with respect to age and type of diseased vessel (although the right coronary artery was more commonly involved in cases of spasm). The overall primary success rate was 72.8% (14/15--93%--in Group I, and 85/121--70.2%--in Group II: no statistically significant difference). The angiographic relapse rate at 6 months was significantly higher in Group I (8/12: 67%) than in Group II (15/63: 23.8%) p less than 0.02. When "redilatation" with stable success is taken into consideration the difference is not significant (33% and 22.2% respectively). The relapses may be dissociated in Group I (2 cases with recurrent spastic angina and normal angiography).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗