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At least 145 records · Page 8Linked to original sources
PubMed1987

Inverted U wave in ergonovine-induced vasospastic angina.

The relationship between inverted U wave in leads V5 and II and the location of myocardial ischemia was studied in 52 positive patients and in 50 negative patients with ergonovine provocation test. Development of a biphasic or negative U wave, or increased negativity of U wave (inverted U wave) was observed in 15 of 17 patients with spasm in only the right coronary artery (RCA), in 6 of 8 with spasm in only the left anterior descending artery (LAD), in 2 of 8 with spasm in only the left circumflex artery (LCx), and in 23 of 24 with spasm in two or more vessels. Of 52 positive patients in the ergonovine provocation test, 46 (88.5%) had inverted U wave. Of these, 17 (32.7%) had inverted U wave without discernible ST deviation. Of 50 negative patients, 2 had inverted U wave. Inverted U wave in lead V5 was frequently seen in patients with spasm of LAD, but this finding was not uncommon in spasm of RCA or LCx. On the other hand, inverted U wave in lead II was frequently seen in spasm of RCA and LCx, but not in spasm of LAD. These findings suggest that inverted U wave in lead V5 is not specific for myocardial ischemia due to spasm of LAD and that inverted U wave in lead II is specific for spasm of RCA and LCx.

Adult↗
PubMedDate not supplied

Effects of angiotensin and ergonovine on large and small coronary arteries in the intact dog.

Angiotensin (ATN) and ergonovine (ERG) are known to cause vasoconstriction of the coronary bed. However, ATN effects have been described mainly on the coronary resistance vessels, while ERG effects have been described on proximal conductance vessels. Recent studies have shown that proximal and distal coronary arteries are regulated independently. To examine both proximal and distal effects of ATN and ERG on the same heart, we studied 7 intact dogs, anesthetized with Innovar (Fentanyl 0.4 mg, Droperidol 20 mg, in 1 ml) and nitrous oxide, which were subjected to direct left anterior (LAD) coronary infusion of angiotensin (0.1, 0.5 and 5 micrograms/min) and ergonovine (0.5, 5, and 25 micrograms/min). Using a quantitative angiographic technique to measure artery dimensions and microspheres to measure flow, ERG infusion showed significant large artery constriction at all doses (maximum: 38.9 +/- 7.8% area reduction), and a significant decrease in LAD coronary artery flow, while endocardial/epicardial flow ratio remained unchanged. ATN produced a biphasic effect on the large coronary arteries. The lowest dose produced constriction (12.3 +/- 3.7% area reduction), which returned toward control value with the 0.5 micrograms/min dose (6.0 +/- 1.0% area reduction), and the 5 micrograms/min dose (1.5 +/- 9.5% area reduction), and no significant changes were observed in LAD flow with ATN infusion. Endocardial/epicardial ratio was unchanged, but aortic pressure was significantly increased during 0.5 and 5 micrograms/min ATN infusion. Coronary resistance (pressure/flow) increased with both ERG and ATN. ERG and ATN produce large and small coronary artery constriction. The coronary response to ERG in dogs is similar to the human coronary response, even though previous data indicated a minimal constrictor response to ERG in canine coronary arteries.

Angiotensin II↗
PubMed1982

Efficacy of chronic amiodarone therapy in patients with variant angina pectoris and inhibition of ergonovine coronary constriction.

In three patients with vasospastic angina pectoris, chronic amiodarone administered orally at doses of 800 and 1,000 mg/day totally suppressed spontaneous episodes of ischemic chest pain for 8 to 14 months. Before treatment, ergonovine maleate 0.2 to 0.4 mg intravenously provoked chest pain and similar ischemic ECG changes as those occurring spontaneously. During amiodarone treatment ergonovine vasoconstriction was totally or partially inhibited. In addition to calcium-blocking agents, amiodarone is another spasmolytic drug which effects smooth muscle relaxation by different mechanisms and appears to be useful for the chronic treatment and prevention of variant angina. The vasodilator property of amiodarone is achieved by both direct action and noncompetitive alpha receptor antagonism of coronary vasculature.

Administration, Oral↗
PubMed2006

Generalized spasm of the right coronary artery after successful stent implantation provoked by intracoronary administration of ergonovine.

Coronary spasm may be one of the reasons for the appearance of chest pain after successful percutaneous coronary interventions, and is potentially hazardous when myocardial ischemia occurs. Coronary spasm can be diagnosed by intracoronary administration of ergonovine as a selective spasm provocative test. We report here the case of a patient who had chest pain and ST segment elevation 10 days after successful right coronary artery stent implantation. Repeat angiography was performed, with results of no in-stent stenosis and no stenosis in other segments. Since coronary artery spasm was considered as a possible reason, a spasm provocative test was attempted. Following ergonovine administration (total dose, 50 mug) into the right coronary artery, severe spasm with 99% stenosis developed over the whole artery except the stented segment. Isosorbide dinitrate was injected immediately, and the provoked spasm was soon relieved. Intravascular ultrasound revealed no neointima at the stented segment and diffuse and mild low-echogenic concentric plaque at the distal as well as proximal segment of the stent. Most reports regarding coronary artery spasm provocative tests have focused on focal lesions before interventional therapy, or during interventional procedures. Although it is quite rare, potential coronary spasm should be considered when chest symptoms recur after percutaneous coronary interventions without angiographic representation.

Coronary Angiography↗
PubMed1979

Ovum transport in women treated with methyl ergonovine.

The location of ova in the genital tract was studied between 24 and 120 hours after the luteinizing hormone (LH) surge in 32 women who had been treated with methyl ergonovine in doses known to stimulate tubal contractility. Thirteen eggs were found in the fallopian tubes, between 48 and 120 hours after th LH peak, and no eggs were recovered from the endoemtrial cavity. No significant difference in tubal ovum recovery or in tubal segmental distribution of ova was found in comparison with these parameters in an untreated control group. These results indicate that stimulation of tubal contractility with methyl ergonovine does not accelerate ovum transport through the fallopian tubes in the human.

Ergonovine↗
PubMed1992

Effects of phenothiazine and thiabendazole on bovine dorsal pedal vein contractility induced by ergonovine and serotonin; potential for alleviation of fescue toxicity.

Phenothiazine and thiabendazole were studied for their ability to antagonize venoconstriction induced by ergonovine, and the biogenic amine serotonin, in the isolated dorsal pedal vein of cattle. The two compounds are commercially available, approved for usage in cattle and have been reported to reverse some of the toxic effects associated with the intake of Acremonium coenophialum-infested fescue forage by cattle. Neither compound had any antagonistic activity against venoconstriction induced by ergonovine. However, thiabendazole did have some activity against venoconstriction induced by serotonin. Ergot alkaloids are known to cause venoconstriction through effects on biogenic amine receptors, including serotonergic receptors, and since thiabendazole has anti-serotonin activity, part of the reported beneficial effects of thiabendazole in alleviating fescue toxicity may be due to the anti-serotonin activity of the drug. Further work is needed to determine if phenothiazine and thiabendazole have any effect on other types of alkaloids that are present in A. coenophialum-infested fescue.

Acremonium↗
PubMed1998

Ergonovine-testing-directed therapy and long-term outcome of sudden-death survivors with no apparent heart disease.

Coronary artery vasospasm, the most common cause of sudden death in patients with structurally normal hearts, is not well recognized. We describe 2 survivors of sudden death with ergonovine-inducible coronary artery vasospasm successfully treated long term with calcium channel blockers. Of the reported (17 worldwide) patients with documented vasospasm-mediated sudden cardiac death treated with calcium blockers, none have had a recurrent event. This is substantially less than the 6-month sudden-death rate of 18 % of untreated vasospasm. We advocate that ergonovine provocative testing of sudden-death survivors with structurally normal hearts, followed by appropriate therapy with calcium channel blockers, be the standard approach for these highly treatable patients.

Adult↗
PubMed1978

Reduction of coronary blood flow during coronary artery spasm occurring spontaneously and after provocation by ergonovine maleate.

A 50-year-old man suffering from recurrent chest pain accompanied by transient ST-segment elevation developed spasm of the left anterior descending coronary artery after receiving ergonovine maleate. During spontaneous chest pain, thermodilution coronary sinus blood flow fell from 96 ml/min to 46 ml/min, while the coronary sinsu arteriovenous oxygen difference widened from 9.82 volumes percent to 11.3 volumes percent. During spontaneous relief of pain, coincident with resolution of the ST-segment changes, coronary sinus blood flow gradually rose to 135 ml/min, while coronary sinus arteriovenous oxygen difference narrowed to 6.82 volumes percent. Similar aterations in coronoary sinus blood flow accompanied chest pain provoked by ergonovine maleate. A thallium-201 scan confirmed a perfusion defect in the distribution the left anterior descending coronary artery. Thus, coronary artery spasm can produce a marked deficity in coronary blood flow that is associated with increased myocardial oxygen extraction; release of spasm creates a hyperemic response.

Coronary Angiography↗
PubMed1980

The angiographic effect of ergonovine and nifedipine in coronary artery spasm.

In a patient with variant angina, we have shown that the calcium-channel blocker nifedipine inhibits both spontaneous and ergonivine-induced coronary artery spasm. It had no effect, however, on the dose-related diffuse vasoconstriction caused by ergonovine, suggesting two distinct responses of coronary arteries to ergonovine provocation. Nifedipine did not cause epicardial coronary artery dilatation, as did nitroglycerin, supporting the rationale of using both therapies together to treat coronary artery spasm.

Adult↗
PubMed1992

Postpartum cerebral angiopathy with cerebral infarction due to ergonovine use.

BACKGROUND AND PURPOSE: Earlier cases of stroke due to postpartum cerebral angiopathy have been reported. The mechanism of this angiopathy has not been explained. CASE DESCRIPTION: We present a case of cerebral infarction with evidence of occlusive change in the vertebrobasilar system as a complication of intravenous ergonovine use after cesarean section delivery. CONCLUSIONS: Ergonovine therapy is a likely cause of so-called postpartum cerebral angiopathy and stroke.

Adult↗
PubMed1990

A case in which coronary spasms were induced by ergonovine provocation at the sites of coronary artery ectasia.

We experienced a patient in whom coronary spasms were induced by an ergonovine provocation test during coronary angiography at the sites of coronary artery ectasia. The patient was a 45-year-old male with chest pain at rest, which promptly disappeared when given sublingual nitroglycerin. Similar attacks occurred frequently even with the administration of drugs after admission, but no significant changes were observed in electrocardiography (ECG) during the attacks or by repeated Holter ECG. The results of exercise ECG and provocation tests such as Valsalva maneuver, hyperventilation, and cold pressor test were negative. Coronary angiography showed ectatic changes in the left coronary artery, and the coronary spasms were induced by ergonovine administration at the ectatic portion of the left anterior descending artery and left circumflex artery, and right coronary artery with chest symptoms similar to those observed during spontaneous attacks. However, there were no significant changes in ECG. This rare case suggests an involvement of spasms in the pathogenic mechanism of myocardial ischemia in coronary artery ectasia.

Coronary Angiography↗
PubMed1992

[The selective induction of a spasm with ergonovine in a normal coronary artery in the presence of contralateral stenosis].

We present a patient with circumflex artery stenosis and recent unstable angina. Selective ergonovine administration on angiographically normal right coronary artery evidenced that at least some of the anginal crisis could be due to spasms of it. We comment the usefulness of the ergonovine intracoronary test in the presence of fixed obstructive lesions.

Angina, Unstable↗
PubMed1989

[The ergonovine test with injection of increasing doses in the diagnosis of chest pain].

Ergonovine testing was performed in 40 patients with normal coronary angiograms (24 men, 16 women, mean age 53 years) complaining of chest pain. Esophageal and coronary spasm were assessed by simultaneous esophageal manometry, 12-lead-EKG and myocardial scintigraphy. Progressive doses of ergonovine were injected. Of the 17 patients experiencing chest pain during testing, coronary spasm occurred in 3 and esophageal motor disorders in 7 (peristaltic contraction waves of high amplitude in 3, diffuse esophageal spasm in 4). The dose necessary was more than 0.175 mg. No objective changes (EKG and manometry) were observed in the 7 remaining patients.

Adult↗
PubMed1987

[Coronary arterial spasm and symptomatology in ischemic and non-ischemic heart diseases: study of the ergonovine maleate provocative test in 3,000 consecutive patients].

We performed coronary angiography and ergonovine maleate provocative tests (EM test) for 3,000 consecutive patients to clarify 1) the incidence of coronary arterial spasm and significant fixed organic stenosis in ischemic and non-ischemic heart diseases, and 2) the relation of these angina-inducing mechanism(s) to rest (R), effort and rest (E & R), and effort (E) angina. Coronary arterial spasm was defined as total or subtotal occlusion induced by ergonovine test, and fixed stenosis was defined as stenosis with more than 70% narrowing of luminal diameter measured after administration of isosorbide dinitrate. Subjects consisted of 3,000 consecutive patients and were categorized in four groups including 1,145 patients who had typical angina pectoris (Group I: rest angina 653, effort angina 230, and combined rest and effort angina 262), 398 patients with myocardial infarction (Group II), 648 patients with atypical chest pain (Group III), and 809 patients who eventually had diagnostic catheterization for heart diseases other than of ischemic nature (Group IV). Results were as follows: 1. The incidence of coronary artery spasm was 22.2% in Group I, 22.9% in Group II, 1.2% in Group III, and 3.7% in Group IV. 2. In Group I, there was a close relationship between the mechanism of angina and the type of occurrence of typical chest pain; coronary artery spasm was more likely observed in rest angina, organic stenosis was observed in effort angina, and the combined type was observed in cases with both spasm and organic stenosis. Furthermore, the occurrence of coronary artery spasm was significantly more frequent in cases with single vessel disease compared with those with multivessel disease (50.7% vs. 26.7%, p less than 0.005). 3. In Group II, the most frequent angiographic evidence was fixed organic stenosis, and there was no relationship between spasm and the numbers of diseased vessels. 4. In Groups III and IV, the most common entity causing coronary artery spasm was hypertrophic cardiomyopathy. In conclusion, two major mechanisms of angina pectoris, i.e., coronary artery spasm and organic stenosis, are closely related to the symptomatology of this disease, such as rest, effort and combined rest and effort types.

Adult↗
PubMed1978

[Reproducibility of the clinical, electrocardiographic and coronarographic aspects of spontaneous coronary spasm with the use of ergonovine maleate].

Five patients affected by angina pectoris showed a spontaneous attack of myocardial ischemia in the course of coronary arteriography examination. During the ischemic episode it was shown a severe coronary arterial spasm promptly relieved by nitroglycerin. In these patients the administration of ergonovine maleate induced the same clinical, electrocardiographic and coronariographic patterns of spontaneous ischemic episodes. These data support the hypotesis that the ergonovine maleate administration is a suitable test for detection of the vasospastic pathogenesis in acute myocardial ischemia.

Adult↗
PubMedDate not supplied

Ergonovine test in coronary disease.

The authors present the role of the Ergonovine test in establishing the diagnosis of the angina produced by coronary spasm. ECG alterations induced by Ergonovine, like transparietal ischemia (monophasic wave) or subendocardic ischemia, not only make possible a correct diagnosis, but they also underline the mechanism of angina and the therapeutical measures. Severe arrhythmias and the danger of sudden death are the two elements illustrating the importance of this coronary spastic mechanism. Nitroglycerine, isosorbidinitrate and calcium antagonists are the drugs of election for the prevention and also for the treatment of coronary spasm.

Adult↗
PubMed1978

Fluoremetric determination of methylergonovine maleate and ergonovine maleate in tablets and injections.

A column cleanup, followed by a shakeout and fluorometric determination, has been developed to determine methylergonovine maleate and ergonovine maleate in tablets and injections. The ether eluate is extracted with tartaric acid solution. An aliquot is diluted with sodium tartrate solution, and this solution is excited at 325 nm. The resulting fluorescence is measured at 432 nm. Results obtained using this method compare favorably with those from the official NF XIV procedure and a semiautomated procedure. Recoveries of 100 and 99% were obtained from one sample each of spiked excipient tablets of methylergonovine maleate and ergonovine maleate, respectively.

Ergonovine↗
PubMed1993

[Chest pain of esophageal origin in patients with a normal coronary angiogram and ergonovine-induced coronary spasm].

In order to differentiate the cardiac or oesophageal origin of chest pain, 55 patients with chest pain, normal coronary arteriogram and normal left ventricular function, were studied. Patients were evaluated with ergonovine test to induce coronary artery spasm and oesophageal function study (including basal manometry in all cases, ClH acid instillation in 53, manometry during ClH instillation in 32 and edrophonium test in 9). There was coronary artery spasm following ergonovine test in 8 patients (group 1) and negative results in 47 (group 2). There was oesophageal disfunction in 50% patients in group 1 and in 62% patients in group 2 (p = NS). The incidence of motor disorders or chest pain following acid instillation was not significatively different in both groups. Nevertheless, in group 1 a tendency to a greater incidence of oesophageal spasm was observed while in group 2 unspecified disorders were more frequent. Thus, in patients with chest pain and normal coronary arteriogram, we always must discard coronary artery spasm and oesophageal disfunction, because, due to a probably common cause, association between both disorders is frequent.

Adult↗