Abstract:
:Coronary (artery) spasm plays an important role in the pathogenesis of ischemic heart disease, including stable angina, unstable angina, myocardial infarction, and sudden death. The prevalence of coronary spasm differs among populations, is higher in Japan and Korea than in the Western countries probably due to genetic as well as environmental factors. Coronary spasm occurs most often from midnight to early morning and is usually not induced by exercise in the daytime. The attacks of coronary spasm are associated with either ST segment elevation or depression, or negative U wave on ECG. Patients with multi-vessel coronary spasm may suffer from lethal arrhythmia, including advanced AV block, ventricular tachycardia or fibrillation, or even sudden death, and they are often resistant to conventional medical therapy including Ca-channel blockers (CCBs). Endothelial nitric oxide (NO) activity is reduced and markers of oxidative stress are elevated in patients with coronary spasm. Thrombogenesis is enhanced and plasma levels of hsCRP and P-selection are elevated in patients with coronary spasm. Thus, patients with coronary spasm have endothelial dysfunction and are suffering from a low-grade chronic inflammation. Polymorphisms of endothelial NO synthase, smoking, and low-grade inflammation are the most important risk factors for coronary spasm. Coronary spasm is a hyper-contraction of coronary smooth muscle triggered by an increase of intracellular Ca2+ in the presence of an increased Ca2+ sensitivity. It has been shown that RhoA/ROCK pathway is involved in Ca2+ sensitivity and that the reduced endothelial NO activity results in increased Ca2+ sensitivity through enhanced RhoA/ROCK pathway. Accordingly, it is possible that in addition to CCBs, RhoA/ROCK pathway blockers may prove to be useful for the treatment of coronary spasm.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Yasue H,Nakagawa H,Itoh T,Harada E,Mizuno Ydoi
10.1016/j.jjcc.2008.01.001subject
Has Abstractpub_date
2008-02-01 00:00:00pages
2-17issue
1eissn
0914-5087issn
1876-4738pii
S0914-5087(08)00002-6journal_volume
51pub_type
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2009-10-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jjcc.2014.11.007
更新日期:2015-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 临床试验,杂志文章
doi:
更新日期:1991-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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pub_type: 杂志文章
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