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Peer-reviewedCC BY-NC-NDCirculation Journal

Time-Dependent Analysis of Blood Sampling to Detect Metabolic Ischemia ― Serial Coronary Artery–Coronary Sinus Lactate Analysis During Acetylcholine Provocation ―

  • Tsuyoshi Ito
  • Masashi Yokoi
  • Shuichi Kitada
  • Yu Kawada
  • Tatsuya Mizoguchi
  • Sayuri Yamabe
  • Atsushi Niwa
  • Toshihiko Goto
  • Yoshihiro Seo
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Abstract

BACKGROUND: The optimal timing for lactate sampling during acetylcholine (ACh) provocation to detect metabolic ischemia remains unclear. METHODS AND RESULTS: In 20 patients with suspected INOCA, blood samples from the coronary artery and coronary sinus were obtained at baseline, every minute for 5 min after ACh, and after nitroglycerin. Metabolic ischemia (negative lactate extraction ratio) occurred in 12 patients: 10 patients exhibited ischemia at 1 min, and 2 patients only at 2 min. No ischemia was observed beyond 3 min. CONCLUSIONS: Sampling at both 1 and 2 min may reduce false-negative detection of metabolic ischemia during ACh provocation.

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Cite

BibTeXRIS
BibTeX
@article{ito2026timedependent,
  title = {{Time-Dependent Analysis of Blood Sampling to Detect Metabolic Ischemia ― Serial Coronary Artery–Coronary Sinus Lactate Analysis During Acetylcholine Provocation ―}},
  author = {Tsuyoshi Ito and Masashi Yokoi and Shuichi Kitada and Yu Kawada and Tatsuya Mizoguchi and Sayuri Yamabe and Atsushi Niwa and Toshihiko Goto and Yoshihiro Seo},
  journal = {Circulation Journal},
  year = {2026},
  month = jul,
  doi = {10.1253/circj.cj-26-0032},
  url = {https://www.jstage.jst.go.jp/article/circj/90/8/90_CJ-26-0032/_article},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Time-Dependent Analysis of Blood Sampling to Detect Metabolic Ischemia ― Serial Coronary Artery–Coronary Sinus Lactate Analysis During Acetylcholine Provocation ―
AU  - Tsuyoshi Ito
AU  - Masashi Yokoi
AU  - Shuichi Kitada
AU  - Yu Kawada
AU  - Tatsuya Mizoguchi
AU  - Sayuri Yamabe
AU  - Atsushi Niwa
AU  - Toshihiko Goto
AU  - Yoshihiro Seo
PY  - 2026
DA  - 2026/07/24
JO  - Circulation Journal
DO  - 10.1253/circj.cj-26-0032
UR  - https://www.jstage.jst.go.jp/article/circj/90/8/90_CJ-26-0032/_article
AB  - BACKGROUND: The optimal timing for lactate sampling during acetylcholine (ACh) provocation to detect metabolic ischemia remains unclear. METHODS AND RESULTS: In 20 patients with suspected INOCA, blood samples from the coronary artery and coronary sinus were obtained at baseline, every minute for 5 min after ACh, and after nitroglycerin. Metabolic ischemia (negative lactate extraction ratio) occurred in 12 patients: 10 patients exhibited ischemia at 1 min, and 2 patients only at 2 min. No ischemia was observed beyond 3 min. CONCLUSIONS: Sampling at both 1 and 2 min may reduce false-negative detection of metabolic ischemia during ACh provocation.
SN  - 1347-4820
SN  - 1346-9843
ER  -