21. The Association of Between Coronary Spasm and B-Type Natriuretic Peptide and Pulse Wave Velocity

Abstract

Background

Coronary spasm cause transient LV dysfunction and consequently may increase BNP by chance. However, the correlation between coronary spasm and BNP has not been verified. We investigated the association between coronary spasm and BNP and pulse wave velocity (PWV) in patients with preserved LV function.

Methods

A patients with chest pain who have ejection fraction >50% underwent both diagnostic coronary angiography with acetylcholine provocation and NT-proBNP measurement simultaneously were enrolled for the study. PWV were done in all patients. Significant coronary artery spasm was defined as focal (>70%) or diffuse severe transient luminal narrowing (>90%) with/without chest pain or ST-T change of ECG.

Results

Among total 1,342 patients, 793 patients with heart failure, arrhythmia, CAD or VHD were excluded and 549 patients were enrolled. Thirty five percent (192/549) of enrolled subjects showed positive result at acetylcholine provocation test. Baseline characteristics were well balanced between the spasm group and control group. In the univariate analysis, the BNP levels of spasm group were lower than control group (146 ± 363 pg/mL vs. 197 ± 532 pg/mL, P = 0.050). But in the multivariate analysis, there was no significant difference of BNP between two groups. Also there is no difference of PWV value between the groups.

Conclusion

There is no significant relationship between BNP, PWV and vasospastic angina. These finding suggest that vasospastic angina with normal left ventricular systolic function is not associated with BNP or PWV.