Cardiac syndrome X: Clinical characteristics revisited

Ezhumalai, Babu; Ananthakrishnapillai, Ajith; Selvaraj, Raja; Satheesh, Santhosh; Jayaraman, Balachander

doi:10.1016/j.ihj.2015.04.022

Cited by 11 publications

(12 citation statements)

References 25 publications

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“…MVA, otherwise called cardiac syndrome X, is a diagnosis of exclusion that has been attributed to coronary microvascular dysfunction (CMD) by many studies. [4][5][6][7][8][9][10][11][12] Contributing factors include endothelial dysfunction, inflammation, atherosclerosis, sluggish coronary blood flow, and increased sympathetic output. It has been found that patients with endothelial dysfunction have reduced levels of endothelium-derived nitric oxide (NO) with elevated levels of endothelin-1 (ET-1), resulting in impaired local vasodilatation at capillary beds.…”

Section: Discussionmentioning

confidence: 99%

“…It has been found that patients with endothelial dysfunction have reduced levels of endothelium-derived nitric oxide (NO) with elevated levels of endothelin-1 (ET-1), resulting in impaired local vasodilatation at capillary beds. 5, 11, 13 The depletion of local NO also favors platelet aggregation and the expression of E-selectin and vascular cell adhesion molecule-1 (VCAM-1), 9, 11, 13 which are both vital inflammatory mediators. Majidinia et al found that MVA patients had elevated levels of ET-1, VCAM-1, and E-selectin at rest compared to controls.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6]8 This is an important clinical entity because the morbidity, risk of major adverse cardiovascular events, and financial implications are comparable to what occurs in patients with obstructive CAD. [6][7][8][9]…”

Section: Introductionmentioning

confidence: 99%

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A Possible Etiopathogenic Role of Sickle Cell Anemia in Ischemia With Nonobstructive Coronary Arteries

Asamoah

2020

Indian Journal of Clinical Cardiology

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Chest pain is a common clinical symptom, especially in patients with sickle cell anemia. Owing to the vast differential diagnosis, investigation can be challenging. Typical chest pain (angina) is often attributed to obstructive coronary artery disease, with patients being referred for exercise stress tests for confirmation. Microvascular angina is emerging as a cause of significant morbidity worldwide, clinically identical to obstructive coronary artery disease. Clinical assessment and exercise stress testing often give the same results, making differentiation difficult. Coronary angiography however shows either normal coronary arteries or a nonobstructive lesion. An incomplete understanding of the etiopathogenesis of microvascular angina may result in missed diagnosis and suboptimal treatment in some cases. Coronary microvascular dysfunction plays a key role in this phenomenon, driven by chronic inflammation, thrombotic microangiopathy, and endothelial dysfunction. This article reports the case of a young man with chest pain, linking the highlights of the pathophysiology of microvascular disease in sickle cell anemia to microvascular angina.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Possible Etiopathogenic Role of Sickle Cell Anemia in Ischemia With Nonobstructive Coronary Arteries

Asamoah

2020

Indian Journal of Clinical Cardiology

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“…With these patients the coronary angiography can appear normal (18). This is usually diagnosed based on chest pain typical for angina, exercise-induced significant ST-segment depression and normal coronary angiograms (19). Syndrome X is diagnosed based on chest pain, exercise-induced ST-segment depression and the absence of either significant epicardial coronary stenosis or vasospasm (20).…”

Section: Methodsmentioning

confidence: 99%

Association between RAGE variants and the susceptibility to atherosclerotic lesions in Chinese Han population

et al. 2019

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Receptor for advanced glycation end products (RAGE) is a major proinflammatory receptor and its role in atherosclerosis has only been emphasized recently. Increasing evidence has demonstrated an association between RAGE and the susceptibility to atherosclerosis development. Therefore, the role of RAGE in atherogenesis and the possible impact of genetic variations in RAGE on the atherosclerotic process in subjects with coronary artery disease (CAD) was investigated in the present study. The RAGE expression in carotid specimens was analyzed by immunohistochemistry and sequence variations of the RAGE gene selected from the Hapmap database were also screened. The plasma levels of S100 calcium binding protein B (S100B) were determined by ELISA. Immunohistochemical staining of tissue samples demonstrated an increased RAGE expression in atherosclerotic carotid plaques compared with that in normal arteries. Furthermore, compared with the corresponding wild-type genotype, the rs2269422 single-nucleotide polymorphism of RAGE was associated with the susceptibility of patients with CAD to atherosclerosis. Furthermore, reverse transcription polymerase chain reaction and western blot analyses indicated increased coronary artery RAGE mRNA levels and protein expression, respectively, in CAD patients vs. control subjects. Furthermore, the plasma levels of S100B in CAD patients that were carriers of the AA/AT genotype of the rs2269422 variant of RAGE was increased compared with that in TT genotype carriers; as this was also identified in control subjects, it may not be CAD-specific. The RAGE rs2269422 variant is therefore significantly associated with an increased occurrence of CAD in the present Han Chinese population. Thus, RAGE variants significantly impact the risk of CAD in Han Chinese subjects.

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“…Согласно Рекомендациям ESC (2019), БКА -это патологический процесс, характеризующийся формированием атеросклеротических бляшек в эпикардиальных артериях, приводящих или не приводящих к их обструкции [1]. В других работах [3][4][5][6][7][8][9] отмечается, что наличие клинических симптомов, типичных для ИБС, и выявление признаков ишемии миокарда с помощью инструментальных методов исследования не всегда сопровождается атеросклеротическим поражением крупных коронарных артерий.…”

Section: обзоры §unclassified

Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes in Primary Health Care – the Issue of Acceptability for the Russian Federation

2020

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In 2019, the European Society for Cardiology (ESC) published guidelines with a new term, “chronic coronary syndromes” (CCS). These guidelines presented 6 clinical scenarios, which are most common in outpatient practice. The diagnostic approach described in these guidelines shifts from the standardization to the rationality of individualized solutions on using various diagnostic methods. The diagnostic approach suggested in the ESC guidelines requires extensive medical discussion and consensus because this will definitely entail a) further increase in indexes that reflect the morbidity of ischemic heart disease (IHD) due to unconfirmed diagnoses and b) administration of unreasoned therapy. This article presents statements of the guidelines, which cannot be automatically transmitted to the existing medical practice and should be discussed and adjusted by experts of the Russian Society of Cardiology.

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Cardiac syndrome X: Clinical characteristics revisited

Cited by 11 publications

References 25 publications

A Possible Etiopathogenic Role of Sickle Cell Anemia in Ischemia With Nonobstructive Coronary Arteries

A Possible Etiopathogenic Role of Sickle Cell Anemia in Ischemia With Nonobstructive Coronary Arteries

Association between RAGE variants and the susceptibility to atherosclerotic lesions in Chinese Han population

Guidelines for the Diagnosis and Management of Chronic Coronary Syndromes in Primary Health Care – the Issue of Acceptability for the Russian Federation

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