Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions
Balloon-injured coronary segments are known to harbor abnormal vasomotion. We evaluated whether de novo coronary lesions treated using drug-coated balloon (DCB) are prone to vasospasm and how they respond to ergonovine and nitrate. Among 132 DCB angioplasty recipients followed, 89 patients underwent...
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/2/299 |
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| author | Sunwon Kim Jong-Seok Lee Yong-Hyun Kim Jin-Seok Kim Sang-Yup Lim Seong Hwan Kim Minjung Kim Jeong-Cheon Ahn Woo-Hyuk Song |
| author_facet | Sunwon Kim Jong-Seok Lee Yong-Hyun Kim Jin-Seok Kim Sang-Yup Lim Seong Hwan Kim Minjung Kim Jeong-Cheon Ahn Woo-Hyuk Song |
| author_sort | Sunwon Kim |
| collection | DOAJ |
| description | Balloon-injured coronary segments are known to harbor abnormal vasomotion. We evaluated whether de novo coronary lesions treated using drug-coated balloon (DCB) are prone to vasospasm and how they respond to ergonovine and nitrate. Among 132 DCB angioplasty recipients followed, 89 patients underwent ergonovine provocation test at 6–9 months follow-up. Within-subject ergonovine- and nitrate-induced diameter changes were compared among three different sites: DCB-treated vs. angiographically normal vs. segment showing prominent vasoreactivity (spastic). No patient experienced clinically refractory vasospastic angina or symptom-driven revascularization during follow-up. Ergonovine induced vasospasm in seven patients; all were multifocal spasm either involving (<i>n</i> = 2) or rather sparing DCB-treated segments (<i>n</i> = 5). None showed focal spasm that exclusively involved DCB-treated lesions. Among 27 patients with vasospastic features, DCB-treated segments showed less vasoconstriction than spastic counterparts (<i>p</i> < 0.001). A total of 110 DCB-treated lesions were analyzed to assess vasomotor function. Vasomotor function, defined as a combined constrictor and dilator response, was comparable between DCB-treated and angiographically normal segments (<i>p</i> = 0.173), while significant differences were observed against spastic counterparts (<i>p</i> < 0.001). In our study, DCB-treated lesions were not particularly vulnerable to vasospasm and were found to have vasomotor function similar to angiographically normal segments, supporting safety of DCB-only strategy in treating de novo native coronary lesions. |
| first_indexed | 2024-03-10T01:13:59Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T01:13:59Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-40ad4eb99e7b41d2928abbbf58a17bed2023-11-23T14:11:39ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111229910.3390/jcm11020299Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery LesionsSunwon Kim0Jong-Seok Lee1Yong-Hyun Kim2Jin-Seok Kim3Sang-Yup Lim4Seong Hwan Kim5Minjung Kim6Jeong-Cheon Ahn7Woo-Hyuk Song8Cardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaCardiovascular Center, Korea University Ansan Hospital, Ansan-si 15355, KoreaBalloon-injured coronary segments are known to harbor abnormal vasomotion. We evaluated whether de novo coronary lesions treated using drug-coated balloon (DCB) are prone to vasospasm and how they respond to ergonovine and nitrate. Among 132 DCB angioplasty recipients followed, 89 patients underwent ergonovine provocation test at 6–9 months follow-up. Within-subject ergonovine- and nitrate-induced diameter changes were compared among three different sites: DCB-treated vs. angiographically normal vs. segment showing prominent vasoreactivity (spastic). No patient experienced clinically refractory vasospastic angina or symptom-driven revascularization during follow-up. Ergonovine induced vasospasm in seven patients; all were multifocal spasm either involving (<i>n</i> = 2) or rather sparing DCB-treated segments (<i>n</i> = 5). None showed focal spasm that exclusively involved DCB-treated lesions. Among 27 patients with vasospastic features, DCB-treated segments showed less vasoconstriction than spastic counterparts (<i>p</i> < 0.001). A total of 110 DCB-treated lesions were analyzed to assess vasomotor function. Vasomotor function, defined as a combined constrictor and dilator response, was comparable between DCB-treated and angiographically normal segments (<i>p</i> = 0.173), while significant differences were observed against spastic counterparts (<i>p</i> < 0.001). In our study, DCB-treated lesions were not particularly vulnerable to vasospasm and were found to have vasomotor function similar to angiographically normal segments, supporting safety of DCB-only strategy in treating de novo native coronary lesions.https://www.mdpi.com/2077-0383/11/2/299drug-coated balloonde novo lesionvasospasmcoronary vasomotor function |
| spellingShingle | Sunwon Kim Jong-Seok Lee Yong-Hyun Kim Jin-Seok Kim Sang-Yup Lim Seong Hwan Kim Minjung Kim Jeong-Cheon Ahn Woo-Hyuk Song Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions Journal of Clinical Medicine drug-coated balloon de novo lesion vasospasm coronary vasomotor function |
| title | Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions |
| title_full | Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions |
| title_fullStr | Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions |
| title_full_unstemmed | Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions |
| title_short | Favorable Vasomotor Function after Drug-Coated Balloon-Only Angioplasty of De Novo Native Coronary Artery Lesions |
| title_sort | favorable vasomotor function after drug coated balloon only angioplasty of de novo native coronary artery lesions |
| topic | drug-coated balloon de novo lesion vasospasm coronary vasomotor function |
| url | https://www.mdpi.com/2077-0383/11/2/299 |
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