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Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm
Published on: September 17, 2021
Relationship between serum lipoprotein(a) concentrations and coronary vasomotion in coronary spastic angina
Keiichi Tsuchida1, Tomoyuki Hori, Naohito Tanabe
1Division of Cardiology, Graduate School of Medical and Dental Sciences, Niigata University. keitsuchida97@kjb.biglobe.ne.jp
Insights
Elevated lipoprotein(a) (Lp(a)) levels are linked to coronary artery issues. This study found higher Lp(a) in patients with coronary spastic angina (CSA) who experienced spasm with lower ergonovine doses, suggesting Lp(a) may indicate disease activity.
Area of Science:
- Cardiology
- Vascular Biology
- Biomarkers
Background:
- Elevated lipoprotein(a) (Lp(a)) impairs endothelium-dependent vasodilation.
- The impact of Lp(a) on coronary spastic angina (CSA) vasomotor abnormalities requires further investigation.
Purpose of the Study:
- To investigate the association between serum Lp(a) concentrations and vasomotor abnormalities in patients with CSA.
Main Methods:
- Assessed 80 spastic coronary artery sites in 80 CSA patients using intracoronary ergonovine (EM) testing.
- Divided spastic sites into two groups based on EM provocation dose (full dose vs. low dose).
- Measured serum Lp(a) concentrations and basal coronary artery tone in patients and controls.
Main Results:
- Patients with low-dose EM-provoked spasm (Group 2) exhibited greater basal coronary artery tone than high-dose provoked spasm (Group 1).
- Serum Lp(a) levels were significantly higher in Group 2 compared to controls and Group 1.
- Multivariate analysis identified serum Lp(a) concentration as the sole predictor of low-dose EM spasm provocation.
Conclusions:
- Serum Lp(a) concentration may serve as a valuable biomarker for assessing disease activity in coronary spastic angina.
- Higher Lp(a) levels are associated with increased coronary artery tone and spasm susceptibility in CSA patients.
Background:
Elevated lipoprotein(a) (Lp(a)) concentrations are reported to impair endothelium-dependent vasodilatation of the epicardial coronary artery. However, the effects on vasomotor abnormalities in coronary spastic angina (CSA) have not been thoroughly investigated.
Methods And Results:
In the present study 80 sites of spasm (spastic sites) without significant organic stenosis (% diameter stenosis <50%) were assessed in 80 patients with CSA diagnosed by intracoronary ergonovine (EM) test. Spastic sites were divided into 2 groups: Group 1 included 30 sites provoked by the full dose (=50 microg) of EM, and Group 2 included 50 sites provoked with less than 50 microg (34.7+/-8.2 microg). Control subjects (n=22) did not show coronary spasm with the EM test. Serum Lp(a) concentrations were measured in all patients. Group 2 had a significantly greater basal coronary artery tone in the spastic sites than Group 1 (p<0.001). Lp(a) level in Group 2 was significantly higher compared with both the control group and Group 1 (p<0.05 by analysis of variance). Multivariate analysis confirmed that only serum Lp(a) concentration was associated with low-dose EM spasm provocation.
Conclusions:
Serum Lp(a) concentration could be a marker for high disease activity in CSA.
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