Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Angina pectoris caused by coronary microvascular spasm

M Mohri1, M Koyanagi, K Egashira

  • 1Research Institute of Angiocardiology and Cardiovascular Clinic, Kyushu University, Faculty of Medicine, Fukuoka, Japan. mmohri@med.kyushu-u.ac.jp

Lancet (London, England)
|June 27, 1998
PubMed
Summary

Coronary microvascular spasm, not just large artery issues, can cause chest pain at rest. This study found microvascular spasm leads to myocardial ischemia in some patients with microvascular angina.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

[Molecular mechanism involved in arteriosclerosis--the roles of nitric oxide and Rho/Rho-kinase].

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·2001
Same author

Adenovirus-mediated transfer of dominant-negative rho-kinase induces a regression of coronary arteriosclerosis in pigs in vivo.

Arteriosclerosis, thrombosis, and vascular biology·2001
Same author

Regression by ACE inhibition of arteriosclerotic changes induced by chronic blockade of NO synthesis in rats.

American journal of physiology. Heart and circulatory physiology·2001
Same author

Glutamate release via NO production evoked by NMDA in the NTS enhances hypotension and bradycardia in vivo.

American journal of physiology. Regulatory, integrative and comparative physiology·2001
Same author

Involvement of Rho-kinase in hypertensive vascular disease: a novel therapeutic target in hypertension.

FASEB journal : official publication of the Federation of American Societies for Experimental Biology·2001
Same author

Activating mutation of D835 within the activation loop of FLT3 in human hematologic malignancies.

Blood·2001

Area of Science:

  • Cardiology
  • Vascular Biology
  • Ischemic Heart Disease

Background:

  • Microvascular angina can manifest during both exercise and rest.
  • While reduced coronary microvessel vasodilator capacity is linked to exercise angina, the cause of rest angina is unclear.
  • This study investigated whether primary hyperconstriction (spasm) of coronary microvessels causes myocardial ischemia at rest.

Purpose of the Study:

  • To test the hypothesis that coronary microvascular spasm is the cause of myocardial ischemia at rest.
  • To differentiate mechanisms of chest pain in patients without significant epicardial coronary artery stenosis.

Main Methods:

  • Intracoronary acetylcholine administration in 117 patients with chest pain and no obstructive epicardial stenosis.
  • Assessment of myocardial lactate metabolism via paired arterial and coronary sinus blood sampling in 36 patients.

Related Experiment Videos

  • Categorization of patients based on large-artery spasm, microvascular spasm, or atypical chest pain.

    • Main Results:

    • 54% of patients had large-artery spasm, 25% had microvascular spasm, and 21% had atypical chest pain.
    • 29 patients with microvascular spasm experienced angina and/or ischemic ECG changes, often induced by acetylcholine.
    • Lactate production during angina was observed in 9 of 11 patients with microvascular spasm; this group had more women and fewer coronary risk factors.

    Conclusions:

    • Coronary microvascular spasm can cause myocardial ischemia.
    • This mechanism may explain chest pain in a subset of patients diagnosed with microvascular angina.
    • Microvascular dysfunction is a significant contributor to ischemic chest pain.