Abstract | OBJECTIVES: In this study, we assessed whether any abnormalities in coronary microvascular and peripheral vasodilator functions are present in patients with variant angina (VA) caused by epicardial coronary artery spasm (CAS). METHODS: We studied 23 patients with VA (i.e. angina at rest, ST-segment elevation during angina attacks and documented occlusive CAS at angiography) and 18 matched healthy controls. Endothelium-dependent and -independent coronary microvascular function was assessed by measuring coronary blood flow (CBF) response to adenosine and the cold pressor test ( CPT) in the left anterior descending artery by transthoracic Doppler echocardiography. Systemic endothelium-dependent and -independent arterial dilator function was assessed by measuring brachial flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD), respectively. RESULTS: In VA patients, CBF responses to both adenosine (1.71 ± 0.25 vs. 2.97 ± 0.80, p < 0.01) and CPT (1.68 ± 0.23 vs. 2.58 ± 0.60, p < 0.01) were reduced compared to controls. Brachial FMD was also lower (3.87 ± 2.06 vs. 8.51 ± 2.95%, p < 0.01), but NMD was higher (16.7 ± 1.8 vs. 11.9 ± 1.4%, p < 0.01) in patients compared to controls. Differences were independent of the presence of coronary atherosclerotic lesions at angiography. CONCLUSIONS: Our data show that patients with VA have a generalized vascular dysfunction that involves both peripheral artery vessels and coronary microcirculation.
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Authors | Rossella Parrinello, Alfonso Sestito, Antonino Di Franco, Giulio Russo, Angelo Villano, Stefano Figliozzi, Roberto Nerla, Pierpaolo Tarzia, Alessandra Stazi, Gaetano A Lanza, Filippo Crea |
Journal | Cardiology
(Cardiology)
Vol. 129
Issue 1
Pg. 20-4
( 2014)
ISSN: 1421-9751 [Electronic] Switzerland |
PMID | 24968863
(Publication Type: Journal Article)
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Copyright | © 2014 S. Karger AG, Basel. |
Topics |
- Aged
- Angina Pectoris, Variant
(etiology, physiopathology)
- Brachial Artery
(physiopathology)
- Case-Control Studies
- Coronary Circulation
(physiology)
- Coronary Vasospasm
(complications, physiopathology)
- Female
- Humans
- Male
- Microcirculation
(physiology)
- Middle Aged
- Regional Blood Flow
(physiology)
- Vasodilation
(physiology)
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