Vasotonic angina: A spectrum of ischemic sysdroms involving function abnormalities of the epicardial and microvascular coronary circulation

Bugiardini, Raffaele; Pozzati, Andrea; Ottani, Filippo; Morgagni, Gian Luigi; Puddu, Paolo

doi:10.1016/0735-1097(93)90045-3

Cited by 82 publications

(36 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, in CSX patients functional abnormalities in the epicardial coronary vessels were reported in previous studies showing impaired endothelium-dependent vasodilatory function in response to vasodilator stimuli and increased vasoconstriction in response to a ergonovine test. 8,9 Similarly, in VA patients, functional alterations of coronary microcirculation were reported in some studies. 10,11 However, no previous studies described clinical symptoms compatible with both forms of angina, suggesting a clinically relevant impairment both of epicardial and microvascular function in the same patients.…”

Section: Discussionmentioning

confidence: 84%

“…Previous studies, however, suggested that functional abnormalities in large coronary arteries may be present in CSX patients. 8,9 Similarly, abnormalities in coronary microcirculation have been described in VA patients. 10,11 No previous study, however, reported clinical evidence of the simultaneous occurrence of angina episodes typical of both VA and of CSX in the same patients.…”

Section: Introductionmentioning

confidence: 89%

See 1 more Smart Citation

Combination of Variant and Microvascular Angina

Infusino

Lanza

Sestito

et al. 2009

Clinical Cardiology

View full text Add to dashboard Cite

Prinzmetal's variant angina (VA) and cardiac syndrome X (CSX) are two distinct, usually easily recognizable, forms of angina syndromes, caused by epicardial spasm, usually responsible for transient transmural myocardial ischemia at rest and by coronary microvascular dysfunction (CMVD), usually responsible for effort induced subendocardial ischemia, respectively. In this article we report clinical evidence in three patients of the simultaneous occurrence of angina episodes typical of both VA and CSX, suggesting that common pathogenetic factors may be responsible for clinical manifestations both of functional macrovascular and microvascular coronary artery abnormalities in some angina patients. Copyright © 2009 Wiley Periodicals, Inc.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 89%

Combination of Variant and Microvascular Angina

Infusino

Lanza

Sestito

et al. 2009

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…раздел 6.7.1. по микрососудистой стенокардии) [498]. Тем не менее, замечание о том, что у этих женщин име-ются "нормальные" коронарные артерии, должно быть пересмотрено в свете дополнительного исследо-вания с ВСУЗИ у женщин в рамках исследования WISE (Women's Ischemia Syndrome Evaluation), кото-рое показало, что в выборке из 100 таких женщин приблизительно у 80% имелся определенный коро-нарный атеросклероз, который сопровождался поло-жительным ремоделированием артерий [499].…”

Section: повторная реваскуляризация у пациентов с предыдущим коронарнunclassified

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Montalescot

Sechtem²,

Achenbach³

et al. 2014

Russ J Cardiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…1,2 Endothelial dysfunction may reside at both epicardial and microvascular levels that may be consistent with both the abovementioned hypotheses. 22 Endothelial dysfunction could be, therefore, a common pathway of different causes leading to chest pain of patients with normal angiograms. It may be due to increased superoxide anion-mediated inactivation of nitric oxide, which causes oxidative stress.…”

Section: Endothelial Dysfunction In Angina With Normal Angiogramsmentioning

confidence: 99%

Angiotensin-Converting Enzyme Inhibitors and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase in Cardiac Syndrome X

et al. 2004

Self Cite

View full text Add to dashboard Cite

Background— Morbidity of patients with Syndrome X (SX; chest pain and normal coronary angiograms) is high and is associated with continuing episodes of chest pain and hospitalization. Impairment of microvascular endothelial function caused by increased oxidative stress has been suggested to be a mechanism of the disease. Superoxide dismutase (SOD) is the major antioxidant enzyme system of the vascular wall. This study sought to establish whether combination treatment with ACE inhibitors and statins reduces oxidative stress and improves quality of life of patients with cardiac SX. Methods and Results— Forty-five patients with SX were randomly assigned to receive either a combination of ramipril (10 mg/d) and atorvastatin (40 mg/d) or placebo for 6 months. We determined the activity of extracellular SOD and its relation to flow-dependent endothelium-mediated dilation (FMD) and quality of life (exercise capacity and score with Seattle Angina Questionnaire [SAQ]) before and after treatment. After 6 months, patients with SX who received atorvastatin and ramipril had significantly reduced ( P =0.001) SOD levels (188.1±29.6 U/mL). No significant changes were seen on placebo (262.9±48.8 U/mL). Reduction of SOD after therapy was negatively correlated with FMD ( r =0.38; P =0.01) and positively with total cholesterol ( r =−0.56; P <0.001). At follow-up, patients taking atorvastatin and ramipril improved their quality of life both in terms of exercise duration (by 23.46%) and SAQ (by 64.1%). Conclusions— Six months of therapy with atorvastatin and ramipril improves endothelial function and quality of life of patients with SX. Reduced SOD activity may reflect low superoxide anion production. Benefits of these drugs may be related to reduction of oxidative stress.

show abstract

Vasotonic angina: A spectrum of ischemic sysdroms involving function abnormalities of the epicardial and microvascular coronary circulation

Cited by 82 publications

References 27 publications

Combination of Variant and Microvascular Angina

Combination of Variant and Microvascular Angina

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Angiotensin-Converting Enzyme Inhibitors and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase in Cardiac Syndrome X

Contact Info

Product

Resources

About