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Central sensitization (CS) is common in microvascular angina (MVA) and significantly worsens chest pain. Targeting CS may improve MVA symptom management beyond standard treatments.

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Area of Science:

  • Cardiology
  • Neuroscience
  • Pain Medicine

Background:

  • Microvascular angina (MVA) causes chest pain despite normal coronary arteries.
  • The role of central sensitization (CS) in amplifying MVA symptoms is not well understood.

Purpose of the Study:

  • To determine the prevalence and impact of central sensitization in patients with confirmed MVA.
  • To investigate the relationship between CS and the burden of angina symptoms in MVA.

Main Methods:

  • A cross-sectional study compared 200 adults with MVA to healthy controls.
  • Participants completed questionnaires assessing central sensitization (CSI), anxiety/depression (HADS), and chest pain.
  • MVA was defined by documented ischemia with ≤50% epicardial stenosis.

Main Results:

  • Patients with MVA had significantly higher mean CSI scores (43 vs. 19) and a higher prevalence of clinically significant CS (62% vs. 10%).
  • In MVA patients, CSI scores strongly correlated with chest pain intensity, frequency, anxiety, and depression.
  • Increased CSI scores were independently associated with higher pain scores, explaining 39% of pain variance.

Conclusions:

  • Central sensitization is highly prevalent in MVA and significantly contributes to the angina burden.
  • These findings suggest a heart-brain interaction in MVA symptom generation.
  • Treatments targeting CS could offer additional benefits for MVA patients.