TY - JOUR
T1 - Peripheral arterial function and coronary microvascular function in patients with variant angina
AU - Parrinello, Rossella
AU - Sestito, Alfonso
AU - Di Franco, Antonino
AU - Russo, Giulio
AU - Villano, Angelo
AU - Figliozzi, Stefano
AU - Nerla, Roberto
AU - Tarzia, Pierpaolo
AU - Stazi, Alessandra
AU - Lanza, Gaetano A.
AU - Crea, Filippo
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
KW - Angina
KW - Coronary microvascular function
KW - Coronary vasospasm
KW - Peripheral vascular function
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U2 - 10.1159/000362380
DO - 10.1159/000362380
M3 - Article
C2 - 24968863
AN - SCOPUS:84902942760
SN - 0008-6312
VL - 129
SP - 20
EP - 24
JO - Cardiology
JF - Cardiology
IS - 1
ER -