Affiliation:
1. Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
Abstract
Recent clinical trials have highlighted that percutaneous coronary intervention in patients with stable angina provides limited additional benefits on top of optimal medical therapy. This has led to much more attention being paid to coronary vasomotion abnormalities regardless of obstructive or non-obstructive arterial segments. Coronary vasomotion is regulated by multiple mechanisms that include the endothelium, vascular smooth muscle cells (VSMCs), myocardial metabolic demand, autonomic nervous system and inflammation. Over the years, several animal models have been developed to explore the central mechanism of coronary artery spasm. This review summarises the landmark studies on the mechanisms of coronary vasospasm demonstrating the central role of Rho-kinase as a molecular switch of VSMC hypercontraction and the important role of coronary adventitial inflammation for Rho-kinase upregulation in VSMCs.
Funder
Ministry of Education, Culture, Sports, Science and Technology
Publisher
Radcliffe Media Media Ltd
Subject
Cardiology and Cardiovascular Medicine
Reference114 articles.
1. Maron DJ, Hochman JS, Reynolds HR, et al. Initial invasive or conservative strategy for stable coronary disease. N Engl J Med 2020;382:1395–407. https://doi.org/10.1056/NEJMoa1915922; PMID: 32227755.
2. Perera D, Clayton T, O’Kane PD, et al. Percutaneous revascularization for ischemic left ventricular dysfunction. N Engl J Med 2022;387:1351–60. https://doi.org/10.1056/NEJMoa2206606; PMID: 36027563.
3. Canty JM Jr. Coronary blood flow and myocardial ischemia. In: Bonow RO, Mann DL, Zipes DP, et al., eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, PA: Saunders, 2012;1049–75.
4. Lanza GA, Pedrotti P, Pasceri V, et al. Autonomic changes associated with spontaneous coronary spasm in patients with variant angina. J Am Coll Cardiol 1996;28:1249–56. https://doi.org/10.1016/S0735-1097(96)00309-9; PMID: 8890823.
5. Li J, Zhang H, Zhang C. Role of inflammation in the regulation of coronary blood flow in ischemia and reperfusion: mechanisms and therapeutic implications. J Mol Cell Cardiol 2012;52:865–72. https://doi.org/10.1016/j.yjmcc.2011.08.027; PMID: 21924274.
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