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Vasospastic angina

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https://www.readbyqxmd.com/read/27904032/coronary-microvascular-dysfunction%C3%A3-epidemiology-pathogenesis-prognosis-diagnosis-risk-factors-and-therapy
#1
Cheng Chen, Janet Wei, Ahmed AlBadri, Parham Zarrini, C Noel Bairey Merz
Angina has traditionally been thought to be caused by obstructive coronary artery disease (CAD). However, a substantial number of patients with angina are found to not have obstructive CAD when undergoing coronary angiography. A significant proportion of these patients have coronary microvascular dysfunction (CMD), characterized by heightened sensitivity to vasoconstrictor stimuli and limited microvascular vasodilator capacity. With the advent of non-invasive and invasive techniques, the coronary microvasculature has been more extensively studied in the past 2 decades...
November 29, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27884129/in-vivo-optical-coherence-tomography-visualization-of-intraplaque-neovascularization-at-the-site-of-coronary-vasospasm-a-case-report
#2
Kenichi Tsujita, Koichi Kaikita, Satoshi Araki, Toshihiro Yamada, Suguru Nagamatsu, Kenshi Yamanaga, Kenji Sakamoto, Sunao Kojima, Seiji Hokimoto, Hisao Ogawa
BACKGROUND: Coronary plaques in patients with coronary vasospastic angina have been characterized by diffuse intima-media thickening with homogeneous fibrous tissue, without confluent necrotic tissue. However, coronary vasospasm can trigger coronary thrombosis, and may play an important role in the pathogenesis of acute coronary syndromes, though the precise morphological mechanisms underlying this process remain unclear. CASE PRESENTATION: A 43-year-old man with a history of multivessel coronary vasospastic angina had been treated with long-acting diltiazem and fluvastatin since 2004...
November 25, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27873006/feasibility-of-omitting-provocation-test-with-50%C3%A2-%C3%AE-g-of-acetylcholine-in-left-coronary-artery
#3
Yuichi Saito, Hideki Kitahara, Toshihiro Shoji, Satoshi Tokimasa, Takashi Nakayama, Kazumasa Sugimoto, Yoshihide Fujimoto, Yoshio Kobayashi
According to the Japanese Circulation Society guideline of vasospastic angina, incremental doses of acetylcholine (ACh) are prescribed for coronary spasm provocation: 20 and 50 μg for the right coronary artery (RCA), and 20, 50 and 100 μg for the left coronary artery (LCA). However, provocation by low doses of ACh in patients with low vasoreactivity may be less needed, and the requirement of 50 μg of ACh for the LCA in these patients has not been evaluated. In the present study, patients who underwent ACh provocation test for both the RCA and LCA were included...
November 21, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27856130/overview-of-the-pharmacological-spasm-provocation-test-comparisons-between-acetylcholine-and-ergonovine
#4
REVIEW
Shozo Sueda, Hiroaki Kohno, Takaaki Ochi, Tadao Uraoka, Kensuke Tsunemitsu
The spasm provocation tests of ergonovine and acetylcholine have been employed in the cardiac catheterization laboratory. Ergonovine acts through the serotogenic receptors, while acetylcholine acts through the muscarinic cholinergic receptors. Different mediators may have the potential to cause different coronary responses. However, there are few reports concerning the coronary response between ergonovine and acetylcholine in the same patients. Acetylcholine is supersensitive for females; spasm provoked by ergonovine is focal and proximal, whereas provoked spasm by acetylcholine is diffuse and distal...
November 14, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27852592/clinical-outcomes-of-vasospastic-angina-patients-presenting-with-acute-coronary-syndrome
#5
Sung Woo Cho, Taek Kyu Park, Hye Bin Gwag, A Young Lim, Min Seok Oh, Da Hyon Lee, Choong Sil Seong, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
BACKGROUND: Coronary vasospasm is an important pathogenesis of acute coronary syndrome (ACS). However, the clinical features and prognosis of vasospastic angina (VA) patients presenting with ACS (VAACS) are still unclear. We aimed to evaluate the clinical characteristics and long-term outcomes of VAACS patients without significant coronary artery stenosis. METHODS AND RESULTS: A total of 986 VA patients confirmed by ergonovine provocation test were analyzed. VAACS was defined as VA patients visiting the emergency room with documented electrocardiographic changes, significant arrhythmias, or elevated cardiac biomarkers...
November 16, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27826349/life-threatening-complication-of-self-made-remedy-for-controlling-high-blood-pressure-coronary-artery-vasospasm-associated-with-iatrogenic-thyrotoxicosis
#6
In Sook Kang, Wook Bum Pyun
We report the case of a middle aged woman who was previously diagnosed with hypertension. She had been drinking a kelp concentrate solution daily for her hypertension instead of taking the prescribed medicine due to her personal beliefs about the kelp solution. As a consequence, she experienced vasospastic angina complicated by myocardial infarction and cardiogenic syncope resulting from iatrogenic thyrotoxicosis. Complementary medicine is widely used by the general population. However, there is still a lack of evidence regarding their efficacy and safety...
November 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27817850/-is-coronary-artery-spasm-a-disease-specific-to-women
#7
X Halna du Fretay, M A Bouzid, B Blanchard-Lemoine, H Benamer
Vasospastic angina is considered rare in Europe but with a prevalence probably underestimated and affects preferentially men in published studies, mostly involving Asian populations. Vasospastic angina in the female population have specificities in terms of pathophysiology, clinical presentation and prognosis, as well as diagnostic strategies currently recommended, that we describe from a clinical case. Although known for over 50years, vasospastic angina remains a disease still insufficiently researched, probably even less in women...
November 3, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27764071/recognizing-and-treating-vasospastic-angina
#8
Leon Chen, Fidelindo Lim
No abstract text is available yet for this article.
November 19, 2016: Nurse Practitioner
https://www.readbyqxmd.com/read/27721853/impact-of-cigarette-smoking-a-3-year-clinical-outcome-of-vasospastic-angina-patients
#9
Byoung Geol Choi, Seung-Woon Rha, Taeshik Park, Se Yeon Choi, Jae Kyeong Byun, Min Suk Shim, Shaopeng Xu, Hu Li, Sang-Ho Park, Ji Young Park, Woong Gil Choi, Yun-Hyeong Cho, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
BACKGROUND AND OBJECTIVES: Cigarette smoking is a risk significant factor in coronary artery disease (CAD) and vasospastic angina (VSA). However, it is largely unknown whether smoking adds to any long-term clinical risk in VSA patients. SUBJECTS AND METHODS: A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395)...
September 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27694191/plasma-concentration-of-serotonin-is-a-novel-biomarker-for-coronary-microvascular-dysfunction-in-patients-with-suspected-angina-and-unobstructive-coronary-arteries
#10
Yuji Odaka, Jun Takahashi, Ryuji Tsuburaya, Kensuke Nishimiya, Kiyotaka Hao, Yasuharu Matsumoto, Kenta Ito, Yasuhiko Sakata, Satoshi Miyata, Daisuke Manita, Yuji Hirowatari, Hiroaki Shimokawa
AIMS: Although the importance of coronary microvascular dysfunction (CMD) has been emerging, reliable biomarkers for CMD remain to be developed. We examined the potential usefulness of plasma concentration of serotonin to diagnose CMD in patients with suspected angina and unobstructive coronary arteries. METHODS AND RESULTS: We enrolled 198 consecutive patients (M/F 116/82, 60.2 ± 13.3 years old) who underwent acetylcholine provocation test and measured plasma serotonin concentration...
October 2, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27693027/diagnostic-performance-of-320-slice-computed-tomography-coronary-angiography-for-symptomatic-patients-in-clinical-practice
#11
Futoshi Yamanaka, Koki Shishido, Tomoki Ochiai, Noriaki Moriyama, Kazuki Tobita, Tomoyuki Tani, Kyosuke Furuhashi, Kazuya Sugitatsu, Daisuke Hachinohe, Tadashi Wada, Shingo Mizuno, Hidetaka Suenaga, Yutaka Tanaka, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shinji Tanaka, Shigeru Saito
OBJECTIVE: Multi-slice computed tomography (MSCT) coronary angiography has been reported as an effective alternative to invasive conventional coronary angiography (CCA) for the diagnosis of coronary artery disease (CAD). However, in previous reports, the diagnostic accuracy of MSCT has not been significant enough to be of benefit in symptomatic patients. The aim of this study was to identify the usefulness of 320-slice computed tomography coronary angiography (320-CTA) for symptomatic patients in terms of the diagnostic accuracy of 320-CTA and the prevalence of vasospastic angina pectoris (VSAP) within the study cohort...
September 29, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27613148/gene-expression-profiling-of-calcium-channel-antagonists-in-the-heart-of-hypertensive-and-normotensive-rats-reveals-class-specific-effects
#12
Carolin Zwadlo, Jürgen Borlak
Calcium channel blockers (CCB) differ in their effects on the cardiovascular system with diltiazem being less negatively ionotrop as compared to verapamil. Diltiazem is mainly used to treat supraventricular tachycardia, vasospastic angina and the Raynaud's syndrome. Little is known about the molecular effects of benzothiazepins on cardiac gene expression. We therefore investigated the effects of diltiazem on cardiac gene expression in normotensive and hypertensive rats with left ventricular hypertrophy and compared the results with our previous findings on verapamil and nifedipine...
September 6, 2016: Vascular Pharmacology
https://www.readbyqxmd.com/read/27573612/impact-of-statin-therapy-on-long-term-clinical-outcomes-of-vasospastic-angina-without-significant-stenosis-a-propensity-score-matched-analysis
#13
Min Seok Oh, Jeong Hoon Yang, Da Hyun Lee, Taek Kyu Park, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
BACKGROUND: Limited data are available on the efficacy of statin therapy for secondary prevention in patients with vasospastic angina (VSA). We investigated the association of statin therapy with long-term clinical outcomes in VSA patients without significant coronary artery disease. METHODS: From January 2003 to June 2014, we enrolled a total of 804 patients with VSA proven by an ergonovine provocation test without significant (≥70% diameter stenosis) coronary artery disease...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27568205/direct-measurement-of-coronary-flow-during-a-vasospastic-angina-attack-by-transthoracic-doppler-echocardiography
#14
Shun Nishino, Nozomi Watanabe, Tatsuya Nakama, Tatsuro Takei, Keiichi Ashikaga, Nehiro Kuriyama, Yoshisato Shibata
No abstract text is available yet for this article.
August 27, 2016: Journal of Echocardiography
https://www.readbyqxmd.com/read/27529589/vasospastic-angina-a-forgotten-acute-coronary-syndrome-and-the-usefulness-of-twelve-lead-electrocardiogram-monitoring-in-diagnosis
#15
Florian Rey, Stéphane Mock, Angela Frei, Stéphane Noble
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27494724/a-case-of-initial-rhythm-of-pulseless-electrical-activity-caused-by-vasospastic-angina
#16
Masaomi Gohbara, Tsutomu Endo, Kazuo Kimura
No abstract text is available yet for this article.
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27444508/impact-of-renin-angiotensin-system-inhibitors-on-long-term-clinical-outcomes-of-patients-with-coronary-artery-spasm
#17
Byoung Geol Choi, Sung Yeon Jeon, Seung-Woon Rha, Sang-Ho Park, Min Suk Shim, Se Yeon Choi, Jae Kyeong Byun, Hu Li, Jah Yeon Choi, Eun Jin Park, Sung-Hun Park, Jae Joong Lee, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh
BACKGROUND: Coronary artery spasm (CAS) is a well-known endothelial dysfunction, and a major cause of vasospastic angina (VSA). The renin-angiotensin system (RAS) is known to be closely associated with endothelial function. However, there are only a few studies that investigated the impact of RAS inhibitor on long-term clinical outcomes in VSA patients. METHODS AND RESULTS: A total of 3349 patients with no significant coronary artery disease, diagnosed with CAS by acetylcholine provocation test were enrolled for this study...
July 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27414736/prognostic-value-of-an-abnormal-response-to-acetylcholine-in-patients-with-angina-and-non-obstructive-coronary-artery-disease-long-term-follow-up-of-the-heart-quest-cohort
#18
Andreas W Schoenenberger, Eric Adler, Samuel Gujer, Peiman Jamshidi, Richard Kobza, Andreas E Stuck, Therese J Resink, Paul Erne
BACKGROUND: This study aims to determine whether small vessel disease (SVD) or vasospastic disease (VSD) has an impact on prognosis. METHODS: The prospective cohort embraced 718 patients with angina equivalent symptoms and no coronary stenosis ≥50% recruited between 1997 and 2008. At baseline, patients were classified as having SVD, VSD, other cardiac disease or non-cardiac problem based on intracoronary acetylcholine application and fast atrial pacing during coronary angiography...
October 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27400315/clinical-implications-of-low-dose-aspirin-on-vasospastic-angina-patients-without-significant-coronary-artery-stenosis-a-propensity-score-matched-analysis
#19
A Young Lim, Taek Kyu Park, Sung Woo Cho, Min Seok Oh, Da Hyon Lee, Choong Sil Seong, Hye Bin Gwag, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joonghyun Ahn, K C Carriere, Seung-Hyuk Choi
BACKGROUND: High-dose aspirin has been reported to exacerbate coronary artery spasm in patients with vasospastic angina. We investigated clinical implications of low-dose aspirin on vasospastic angina patients without significant coronary artery stenosis. METHODS: We included patients without significant coronary artery stenosis on coronary angiography (CAG) and with positive results on intracoronary ergonovine provocation test between January 2003 and December 2014...
October 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27390950/impact-of-aspirin-on-the-prognosis-in-patients-with-coronary-spasm-without-significant-atherosclerotic-stenosis
#20
Masanobu Ishii, Koichi Kaikita, Koji Sato, Kenshi Yamanaga, Takashi Miyazaki, Tomonori Akasaka, Noriaki Tabata, Yuichiro Arima, Daisuke Sueta, Kenji Sakamoto, Eiichiro Yamamoto, Kenichi Tsujita, Megumi Yamamuro, Sunao Kojima, Hirofumi Soejima, Seiji Hokimoto, Kunihiko Matsui, Hisao Ogawa
BACKGROUND: Coronary spasm is one of the mechanisms of myocardial infarction with nonobstructive coronary arteries (MINOCA). The aim of this study was to investigate the effects of aspirin on future cardiovascular events in patients with coronary vasospastic angina (VSA) with non-significant atherosclerotic stenosis. METHODS: This was the retrospective analysis of the 640 VSA patients with non-significant atherosclerotic stenosis (≤50% stenosis) among 1,877 consecutive patients who underwent acetylcholine (ACh)-provocation testing between January 1991 and December 2010...
October 1, 2016: International Journal of Cardiology
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