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Reactivity-based coronary vasospasm independent of atherosclerosis in rhesus monkeys.

Abstract：

OBJECTIVES:We studied the hypothesis that in the absence of vascular pathology, coronary artery vasospasm occurs as a result of local regions of vascular muscle hyperreactivity. We aimed to explore the basis for a functional etiology of those vasospasms not explained on a structural basis. BACKGROUND:Ovariectomized rhesus monkeys (Macaca mulatta) without injury or significant vascular disease were stimulated with platelet release products, and angiograms were compared with those from vasospasms induced in human patients. METHODS:We used intracoronary (IC) injections of serotonin, thromboxane A2 (U46619), endothelin 1 or angiotensin II in concentrations 3 to 10 times that which reduced coronary artery diameter by 50%. RESULTS:Although no agent alone caused vasospasm, the combination of pathophysiologic concentrations of serotonin and the stable thromboxane A2 mimetic, U46619, injected through an IC catheter, synergistically caused coronary vasospasm on the second or third challenge in five of seven monkeys. These drug-induced vasospasms were similar to vasospasms induced by mechanical injury followed by serotonin, and to those stimulated in human IC diagnostic tests, as judged by onset, appearance, kinetics and vasodilator reversal. CONCLUSIONS:These studies in ovariectomized monkeys revealed that coronary vasospasm can be stimulated without preexisting vascular pathology, endothelial denudation or injury. Reproducible vasospasm of primate coronary arteries in response to these two endogenous pathophysiologic vasoconstrictors, which are thought to be precipitating stimuli in the etiology of vasospasm, suggests that structure-independent epicardial vasospasm can be an important element in serious cardiac ischemic events, particularly the focal, persistent vasospasms that occur without plaques or injury.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Hermsmeyer K,Miyagawa K,Kelley ST,Rösch J,Hall AS,Axthelm MK,Greenberg B

doi

10.1016/s0735-1097(96)00524-4

subject

Has Abstract

pub_date

1997-03-01 00:00:00

pages

671-80

issue

eissn

0735-1097

issn

1558-3597

pii

S0735109796005244

journal_volume

pub_type

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Reactivity-based coronary vasospasm independent of atherosclerosis in rhesus monkeys.