The Changes of Fractional Flow Reserve after Intracoronary Nitrate and Nicorandil Injection in Coronary Artery Ectasia

ABSTRACT

BACKGROUND AND OBJECTIVES: Little data exist relating to the mechanism of myocardial ischemia in patients with coronary artery ectasia (CAE). The purpose of this study was to evaluate the fractional flow reserve (FFR), as an index of myocardial ischemia, in patients with CAE. SUBJECTS AND METHODS: Ten patients (7 males, 54.0+/-12.6 years) who diagnosed as CAE, by coronary angiographies, between March 2002 and July 2002, were analyzed. The clinical diagnosis of all the patients was unstable angina. FFR were performed using a pressure wire on the patients diagnosed with slow flow CAE from their coronary angiograms. After measurement of the baseline FFR using adenosine 20 microgram for the right coronary artery, and 24 microgram for the left anterior descending artery, the changes in the FFR with 500 microgram of intracoronary nitrate and 2 mg of Nicorandil were observed. RESULTS: Smoking was the most frequently associated risk factor. Type I CAE, according to Markis' classification, was the most prevalent at 60.0%. The values of the baseline FFR in the left anterior descending artery and right coronary artery, following the intracoronary injection of adenosine were both normal, and there were no significant changes in the FFR following the intracoronary injections of nitrate and Nicoronadil. CONCLUSION: The value of the FFR with CAE was normal, and an intracoronary injection of vasodilators did not change the FFR in patients with CAE. Therefore, vasodilator therapy might be beneficial for patients with symptomatic CAE.