Preserved endothelium-dependent vasodilation at the vasospastic site in patients with variant angina

Kensuke Egashira, Tetsuzi Inou, Akira Yamada, Yoshitaka Hirooka, Akira Takeshita

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Abstract

Endothelial dysfunction has been implicated as a cause of coronary vasospasm in patients with variant angina. This study aimed to determine if endothelium-dependent vasodilation evoked with substance P (SP) was altered at the spastic site where vasospasm was induced by acetylcholine (ACH) in patients with variant angina. It has been shown that SP evokes endothelium-dependent vasodilation with no direct effect on vascular smooth muscle in excised human coronary arteries. SP and ACH were infused into the coronary arteries in nine patients with variant angina in whom coronary arteriograms showed normal or mild atherosclerotic lesions. The vasomotor responses of coronary arteries were assessed by quantitative arteriography. ACH at a high dose (100 μg/min) provoked coronary vasospasm associated with anginal attack in all patients. In contrast, SP at graded doses (13.5, 40, and 135 ng/min) caused the dose-dependent and comparable increases in the coronary diameter at the spastic and control sites. ACH at a low dose (10 μg/min) also caused comparable vasodilation at the spastic and control sites in patients with normal coronary arteries. Coronary vasodilating responses to SP were comparable in patients with variant angina and those with atypical chest pain. The results indicate that endothelium-dependent vasodilation evoked with SP and ACH at the low dose was present at the vasospastic site in patients with variant angina. These findings suggest that the ACH-induced coronary vasospasm in patients with variant angina results from hyperreactivity of vascular smooth muscle to ACH but not from endothelial dysfunction.

Original languageEnglish
Pages (from-to)1047-1052
Number of pages6
JournalJournal of Clinical Investigation
Volume89
Issue number3
DOIs
Publication statusPublished - Jan 1 1992

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Vasodilation
Endothelium
Acetylcholine
Substance P
Coronary Vasospasm
Muscle Spasticity
Coronary Vessels
Vascular Smooth Muscle
Chest Pain
Angiography

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Preserved endothelium-dependent vasodilation at the vasospastic site in patients with variant angina. / Egashira, Kensuke; Inou, Tetsuzi; Yamada, Akira; Hirooka, Yoshitaka; Takeshita, Akira.

In: Journal of Clinical Investigation, Vol. 89, No. 3, 01.01.1992, p. 1047-1052.

Research output: Contribution to journalArticle

Egashira, Kensuke ; Inou, Tetsuzi ; Yamada, Akira ; Hirooka, Yoshitaka ; Takeshita, Akira. / Preserved endothelium-dependent vasodilation at the vasospastic site in patients with variant angina. In: Journal of Clinical Investigation. 1992 ; Vol. 89, No. 3. pp. 1047-1052.
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