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PubMed1997

Plasma concentrations of prolactin, growth hormone, and luteinizing hormone in steers administered ergotamine or ergonovine.

This research investigated whether ergot alkaloids associated with endophyte-infected tall fescue could alter plasma concentrations of pituitary hormones that regulate biological processes related to cattle performance. Seven Angus yearling steers received single i.v. injections of ergotamine tartrate, ergonovine maleate, or saline vehicle in a simple cross-over design. Each steer was given a different compound each week. Blood samples were collected at 15-min intervals for 45 min before and 240 min after treatments to assess plasma concentrations of prolactin, growth hormone, and LH. Respiratory rates were measured hourly to ascertain a systemic effect. Ambient temperature averaged 34 degrees C during data collection. Treatment x time was a significant source of variation for respiration rate and plasma concentrations of each hormone evaluated. Respiration rates were higher for ergonovine than for saline (P < .02) and ergotamine (P < .07) 30 min after treatment, but they were higher (P < .05) for ergotamine than for ergonovine and saline by 210 min after treatment. Both alkaloids transiently elevated (P < .01) plasma growth hormone concentrations compared with before alkaloid treatment and after saline treatment. Ergotamine reduced (P < .01) plasma concentrations of prolactin and LH throughout the 120-min period after treatment compared with concentrations before ergotamine treatment and after saline treatment. Ergonovine lowered (P < .01) prolactin concentrations for a shorter time than ergotamine and did not affect mean LH concentrations. Results indicated that ergot alkaloids implicated as contributing agents to fescue toxicosis can alter plasma concentrations of pituitary hormones important to cattle production.

Animals↗
PubMed1998

Reproductive hormonal responses to ergotamine and ergonovine in cows during the luteal phase of the estrous cycle.

We conducted research to evaluate whether ergot alkaloids associated with endophyte-infected tall fescue could alter plasma concentrations of hormones important to reproductive function in cows. Six primiparous, estrous-cycling Holstein cows nursing calves received single i.v. injections of ergotamine tartrate, ergonovine maleate, or saline vehicle in a simple cross-over design. Each cow received one compound per estrous cycle, d 15 or 16 after estrus, and all compounds over three estrous cycles. Blood samples were collected at 20-min intervals for 40 min before and 240 min after treatments to assess plasma concentrations of prolactin, LH, FSH, and the response by PGF2alpha metabolite 13,14-dihydro-15-keto-prostaglandin F2alpha (PGFM). Ambient temperature and respiratory rates were measured hourly. Ambient temperature averaged 26 degrees C during data collection. Treatment x time was a significant source of variation for respiration rate and plasma concentrations of every hormone evaluated except FSH. Ergotamine elevated (P < .01) respiration rates 2 to 4 h after treatment. Ergotamine and ergonovine reduced (P < .001) plasma concentrations of prolactin for 2 to 4 h after treatment compared to concentrations before treatment. Plasma concentrations of LH were lowered (P < .01) by ergonovine during the 3rd h after treatment and by ergotamine during the 4th h after treatment. Most cows exhibited secretory PGFM responses after ergotamine and ergonovine treatments compared with an absence of a PGFM response in all cows after saline (P < or = .01). Results indicated that ergot alkaloids implicated as causative agents for fescue toxicosis can alter plasma concentrations of reproductive hormones during the late luteal phase of the estrous cycle in cows.

Animals↗
PubMed2003

Modulation of cytochrome P450 metabolism by ergonovine and dihydroergotamine.

This study investigated modulation of the cytochrome P450 3A (CYP3A4)-mediated metabolism of ergotamine (ET) by ergonovine and dihydroergotamine. Liver microsomes were prepared from rats treated i.p. for 4 d with: low (10 mM) or high (100 mM) levels of dexamethasone (DM10 and DM100), dihydroergotamine, ergonovine, or control. Cytochrome P450 activity was evaluated using ET and its isomers as substrate. Ergotamine was converted to its metabolites at rates of 0.385 or 0.535 (SE = 0.040) nM/microg protein/min when incubated with liver microsomes from DM10 or DM100 treated rats, respectively. These rates were higher than for rats on other treatments. Induction of CYP34A activity was not greater for ergonovine or dihydroergotamine treatments than for controls. Both ergonovine and dihydroergotamine treatments inhibited in vitro CYP3A4 activity in a dose dependent manner producing quadratic inhibition curves.

Animals↗
PubMedDate not supplied

Failure of ketanserin, a serotonin inhibitor, to prevent spontaneous or ergonovine-induced attacks of variant angina.

Six patients hospitalized with active variant angina were treated for 3 days with the serotonin antagonist ketanserin after a 3 day control period on no medication. The number of variant angina episodes per patient per day was 1.52 +/- 1.42 during the control period and 2.05 +/- 2.30 during ketanserin therapy (p = NS). Ergonovine was administered in incremental doses of 0.0125 mg to 0.4 mg in the control period, during intravenous ketanserin administration and after 3 days of oral treatment. All 6 patients developed ST elevation during all 3 ergonovine tests. The ergonovine dose at which ST elevation developed was similar in each of the 3 periods. It is concluded that ketanserin is of no value in the treatment of variant angina and that both spontaneous and ergonovine-induced coronary spasm in man are unlikely to be mediated by a serotonergic mechanism.

Aged↗
PubMed1984

Catecholamine release in coronary sinus during vasospastic angina induced by ergonovine.

In seven patients with spontaneous angina and three control subjects, aortic and coronary sinus norepinephrine and epinephrine were assessed. Samples were taken in basal conditions and during ergonovine test in coronary sinus and aorta. The behaviour of some hemodynamic parameters as heart rate, blood pressure, left ventricular end diastolic pressure and coronary sinus flow was also studied. Resting myocardial norepinephrine and epinephrine flux was similar for both groups. In ischemic patients ergonovine induced a coronary spasm accompanied by an evident reduction of coronary sinus flow and a slight increase in arterial epinephrine and norepinephrine concentrations. However, a significant decrease in the net myocardial norepinephrine and epinephrine release was evidenced. After ergonovine, not significant changes in norepinephrine and epinephrine concentration and release resulted in control subjects. The increase in peripheral catecholamine concentrations found in ischemic patients during ergonovine test could represent a reflex activation of sympathetic activity induced by an ischemia dependent ventricular mechanical disfunction. The decrease in myocardial catecholamine release during angina could be justified by sequestration of epinephrine and norepinephrine in ischemic areas induced by vasospasm or reflex inhibition of cardiac sympathetic tone.

Adult↗
PubMed1984

Ergonovine-provoked esophageal spasm during coronary angiography.

In many patients with chest pain of esophageal origin, findings are normal on routine esophageal manometry and dysmotility develops only upon provocation with ergonovine maleate. Unfortunately, ergonovine may induce myocardial ischemia in patients in whom coronary artery spasm did not occur during previous provocative testing in a cardiac laboratory-limiting its clinical usefulness. We have recorded esophageal pressure simultaneously with ergonovine infusion during angiography in ten patients without significant arterial stenoses. In two patients their usual chest pain developed associated with esophageal spasm and without changes in coronary vessels. Simultaneous performance of angiography and manometry enhanced the diagnostic yield of provocative testing by showing esophageal motility changes. This method may detect significant changes in the esophageal motility, is easy to carry out and does not interfere with angiography. It maximizes the information gained from a single provocative test and avoids the risk of ergonovine infusion outside of a cardiac laboratory.

Adult↗
PubMed1981

Provocation of esophageal pain by ergonovine or edrophonium.

Ten patients with anginal symptoms and ergonovine-induced chest pain without coronary artery spasm had esophageal manometry with provocative pharmacologic testing. Increased amplitude of esophageal contractions on baseline manometry (68.2 +/- 10.3 mmHg) was the only characteristic discriminating these patients from normals (40.9 +/- 6.3 mmHg) and from patients with esophageal motility disorders (39.6 +/- 7.5 mmHg). The administration of ergonovine or edrophonium provoked typical chest pain in association with high amplitude, long duration, and repetitive esophageal contractions in all 10 patients. Patients with esophageal motor disorders showed a similar, but less marked esophageal response with pain infrequently produced. Normals showed no response to ergonovine, and a minimal response to edrophonium, but without chest pain. Clinical features of patients with ergonovine-induced chest pain could not distinguish them from patients with coronary artery disease; esophageal symptoms were infrequent and mild. These studies suggest that certain patients with chest pain of esophageal origin may be identified only by provocative testing during esophageal manometry. However, these provocative drugs may also induce coronary artery spasm and should not be used during routine clinical manometry.

Adult↗
PubMed1976

Effect of ergonovine on prolactin secretion and milk let-down.

The effect of ergonovine maleate on prolactin secretion and lactation was determined in 10 puerperal women. Serum prolactin concentration measured by radioimmunoassay resulted in 537.2 +/- 45.9 ng/ml (M +/- SE) before the oral administration of 0.6 mg ergonovine maleate, and 89.7 +/- 25.6 ng/ml after 7 days of therapy. The serum prolactin concentration seen in the control group of nonlactating women (562.0 +/- 36.1 and 218.0 +/- 27.3 ng/ml) was significantly greater than (P less than 0.01) that seen in the treated group. In 2 additional patients it was also demonstrated that the simultaneous administration of ergonovine by oral and intravenous routes potentiates the suppressive effect on prolactin secretion. Three of the 10 treated women showed progressive inhibition of lactation. This study shows that ergonovine maleate interferes with prolactin secretion, and may decrease milk production.

Administration, Oral↗
PubMed1988

[Effect of ergonovine and the cold stress test on time intervals of left ventricular systole and their significance for the diagnosis of coronary heart disease].

In 20 healthy test persons and 44 patients with a coronary heart disease without stenocardia at rest the ergonovine and the cold pressure test were performed. During the tests the ECG in 12 standard leads and the mechanocardiogrammes were registered, from which the time intervals of the left-ventricular systole were calculated. From the analysis of the pectanginous complaints and/or from the changes of the ST segment for the diagnosis of the coronary heart disease a sensitiveness of the ergonovine test of 40% was obtained, whereas the sensitiveness of the cold tolerance test was only 10%. In healthy test persons during the ergonovine test a shortening of Q-1, a decrease of the quotient PEP/LVET and a prolongation of LVETI were established. Apart from this, in patients with coronary heart disease also shortenings of ICT and PEP and an increase of the quotient LVET/S1S2 were made evident. During the cold tolerance test in healthy test persons, besides the prolongation of LVETI, no other changes were stated. On the other hand, in the patients a decrease of the quotient PEP/LVET and a shortening of PEP were existing. The diagnostic value of the analysis of the left-ventricular time intervals was insignificantly higher during the ergonovine test than at rest. However, during the cold pressure tests no differences were stated. The application of the analysis of the left-ventricular time intervals does not essentially enlarge the sensitiveness of the two tests in comparison to the analysis of the changes of the ST segment in the ECG.

Angina Pectoris, Variant↗
PubMed1982

Limitations of ergonovine testing in patients with variant angina.

Fourteen patients with variant angina underwent ergonovine testing during diagnostic coronary angiography. The clinical electrocardiographic or angiographic manifestations of coronary artery spasm could not be reproduced in six of these patients. Five patients had chest pain and transient ST-segment elevation within 4 days of the ergonovine study, including three who developed coronary spasm in the catheterization laboratory. It appears that the sensitivity of ergonovine testing in the diagnosis of coronary spasm is lower than previously emphasized.

Adult↗
PubMed1993

Coronary artery spasm culminating in thrombosis following ergonovine stimulation.

A 53-yr-old active man with angina but no angiographically significant obstructive coronary artery disease developed refractory spasm following ergonovine provocation. This resulted in thrombus formation and myocardial infarction. As such, this is the first case in which thrombosis developed at the site of intense coronary artery spasm induced by ergonovine, all of which were documented angiographically. Despite the notable safety of this test, this case re-emphasizes the potential of ergonovine to produce intractable myocardial ischemia and infarction.

Cardiac Catheterization↗
PubMed2000

Acetylcholine- and ergonovine-induced coronary microvascular spasm reflected by increased coronary vascular resistance and myocardial lactate production.

Diagnosis of coronary microvascular spasm remains largely speculative because it has been mostly based on chest pain and electrocardiographic ST-segment shift with slow filling of contrast medium into the coronary artery. A patient with resting chest pain and normal coronary angiograms underwent provocative tests with intracoronary acetylcholine (ACh) and ergonovine. During the tests, coronary diameter and flow velocity in the left anterior descending (LAD) coronary artery were measured with quantitative coronary angiography and intracoronary Doppler guide wire, respectively. Vascular resistance of the LAD and lactate production were determined separately. With injections of 100 microg of ACh and 20 microg of ergonovine, chest pain occurred with ST-segment elevation in the precordial leads in the absence of epicardial coronary spasm. Coronary vascular resistance increased by 2.2- and 1.6-fold of the baseline value with ACh and ergonovine, respectively. Myocardial lactate production was noted during the ST-segment elevation. Coronary microvascular spasm was verified by the increment in coronary vascular resistance and myocardial lactate production with concomitant ST-segment elevation in the presence of normal coronary angiograms.

Acetylcholine↗
PubMed1981

Application and safety of outpatient ergonovine testing in accurately detecting coronary spasm in patients with possible variant angina.

We analyzed the results of 61 consecutive outpatient ergonovine provocation tests to determine the safety and efficacy of such outpatient testing for detecting coronary artery spasm (CAS). Criteria for outpatient testing included: clinical history suggestive of variant angina, noncritical coronary artery disease documented by coronary arteriography, normal exercise treadmill test, no symptomatic arrhythmias, and no history of recent myocardial infarction. All antianginal medications were tapered and stopped. Ergonovine maleate was given as a bolus at 3-minute intervals in consecutive doses of 0.05, 0.10, and 0.25 mg. A positive test was defined as chest pain accompanied by greater than 0.1 mV ST segment elevation of 12-lead ECG. If pain and ST-segment elevation occurred, intravenous and sublingual nitroglycerin were immediately administered for relief of myocardial ischemia. Of the 61 patients studied, 10 had positive tests; there were no complications. Follow-up the 51 patients with negative studies has not revealed cardiac etiology for their chest pain. We conclude that outpatient ergonovine testing is a safe and accurate diagnostic test for identifying CAS in a highly selected population of patients with possible variant angina when performed under carefully controlled conditions.

Adult↗
PubMed1986

Differential transmyocardial platelet behavior in response to pacing and ergonovine-induced myocardial ischemia.

In 17 anginal patients with critical narrowing of the left anterior descending artery, we studied the effects of acute ischemia, either induced by atrial pacing or by ergonovine, on transmyocardial platelet behavior. Six other patients with atypical chest pain and normal coronary arteries served as controls. Simultaneous arterial and great cardiac vein samples were drawn during control and ischemia to measure the levels of platelet factor four (PF4) and beta-thromboglobulin (BTG). During pacing-induced ischemia the great cardiac vein-arterial differences of PF4 and BTG decreased significantly, indicating a reduced platelet aggregability; no significant changes were observed in the control patients. By contrast, when ischemia resulted from ergonovine-induced spasm of the left anterior descending artery (five patients), the great cardiac vein-arterial differences increased, indicating enhanced platelet aggregability. Again no differences were observed in the patients with a negative ergonovine test. The results of our study suggest that the transcardiac platelet behavior may vary during different ischemic conditions. When ischemia is due to increased myocardial demands and flow is normal or increased, myocardial metabolites released from the ischemic area may oppose platelet aggregation. By contrast, spasm and the stagnant flow resulting from it may enhance platelet aggregation.

Adult↗
PubMed1992

Long-term study of recurrent vasospastic angina using coronary angiograms during ergonovine provocation tests.

Chronologic changes of coronary spasm were examined by repeated ergonovine provocation tests during angiography. A total of 322 patients who had variant angina without severe atherosclerosis demonstrated a positive response to the first test. Ninety of these patients had recurrent variant anginal symptoms after an angina-free period of 38 +/- 12 months (mean +/- SD). Of these 90 patients, 76 (84%) had symptoms or electrocardiographic (ECG) findings similar to those of the first test. The initial 9 of these 76 patients underwent a second provocation test and showed coronary responses analogous to those on the first test. Of the 90 patients, 14 (16%) had different symptoms or ECG findings from those elicited at the first episode. All 14 patients again had a positive response to a second ergonovine test and the following angiographic changes were observed in the three major vessels between the two tests. Of the 21 vessels that had spasm on the first test, eight vessels (19%) did not have spasm on the second test. Of the 21 vessels that did not demonstrate spasm on the first test, 10 (24%) demonstrated spasm on the second test. In the present study it is concluded that the majority of patients with recurrent angina seemed to have consistency in the location of coronary spasm, while in some patients the fluctuation of coronary spasm was confirmed by two ergonovine provocation tests.

Adult↗
PubMed1977

Provocation of coronary spasm with ergonovine maleate. New test with results in 57 patients undergoing coronary arteriography.

Ergonovine maleate (Ergotrate) was given to 57 patients undergoing coronary arteriography for investigation of angina occurring at rest or without provocation when routine study showed normal arteries or insufficient occlusive disease to explain their symptoms. This provocative test induced coronary arterial spasm in 13 patients, 10 of whom had definite Prinzmetal's angina. The spasm was easily reversed with sublingually administered nitroglycerin. The spasm was occlusive or nearly occlusive in nine patients, and there was associated reproduction of the chest pain and S-T elevation similar to the spontaneous episodes. One patient with Prinzmetal's angina had S-T depression rather than elevation in association with the chest pain. The other three patients without Prinzmetal's angina had focal narrowing without coronary occlusion, reproduction of the chest pain or electrocardiographic changes. Of the 44 patients who did not demonstrate coronary spasm in response to ergonovine, 29 had normal coronary arteries and 15 had various degrees of atherosclerotic occlusive disease. We conclude that cautious administration of ergonovine maleate during coronary arteriography can be safely used to elicit coronary spasm in some patients who have insufficient fixed occlusive disease to explain their symptoms.

Adult↗
PubMed1981

Nifedipine blockade of ergonovine-induced coronary arterial spasm: angiographic documentation.

To determine whether calcium-flux blockade with nifedipine blunts coronary vasospasm, four patients with angiographically demonstrable coronary arterial spasm in the absence of significant fixed coronary arterial stenosis were evaluated with coronary arteriography before and after treatment with nifedipine. After initial coronary arteriography, ergonovine was administered in successive doses of 0.05, 0.1 and (when necessary) 0.2 mg intravenously at 3 minute intervals. Three patients had symptomatic high grade focal coronary arterial spasm with electrocardiographic changes, and the fourth exhibited asymptomatic 60 percent constriction of the left anterior descending coronary artery. A maximal ergonovine challenge was repeated 30 minutes later after each patient had been pretreated with a 20 mg sublingual dose of nifedipine. Under these conditions, no patient had chest pain or electrocardiographic changes. Furthermore, neither focal nor diffuse coronary arterial spasm was demonstrable angiographically after the second challenge. Thus, in each case, a single dose of nifedipine precluded the angiographic expression of ergonovine-provoked coronary arterial spasm.

Angina Pectoris↗
PubMed1981

Coronary arterial spasm versus esophageal spasm. Response to ergonovine.

In this report we show that coronary arterial and esophageal spasm are sometimes clinically indistinguishable. Pain patterns can be identical, nitroglycerin can bring relief, interval electrocardiograms and exercise electrocardiograms generally disclose no abnormalities, coronary arteriograms may be within normal limits or nearly so, and, importantly, an ergonovine provocative test can provoke esophageal spasm accompanied by pain mistaken for Prinzmetal's angina. Accordingly, chest pain in response to the administration of ergonovine is not evidence of coronary arterial spasm without simultaneous arteriographic proof together with changes in the monitoring electrocardiogram. Conversely, gastroenterologists should not expose patients to the risk of ergonovine without prior assurance that the coronary arterial response is normal. Our observations illustrate these points and identify a patient with symptomatic esophageal spasm previously diagnosed as Prinzmetal's angina.

Angina Pectoris↗