Alterations of Autonomic Nervous Activity Associated with Spontaneous Coronary Spasm in Patients with Variant Angina

Kim, Nam Ho; Jeong, Jin Won; Park, Eun Mi; Yun, Kyung Ho; Yoo, Nam Jin; Lee, Eun Mi; Oh, Seok Kyu; Park, Ock Kyu

doi:10.4070/kcj.2004.34.4.362

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…According to these authors, the power spectral density of the low frequency component was increased before the onset of cardiac attack. This indicates that activation of the sympathetic nervous system might play a crucial role in the development of vasospasm12, 13).…”

Section: Discussionmentioning

confidence: 99%

An Increased Monocyte Count Predicts Coronary Artery Spasm in Patients with Resting Chest Pain and Insignificant Coronary Artery Stenosis

Yun

Park

et al. 2006

Korean J Intern Med

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BackgroundCoronary atherosclerosis with inflammation gives rise to coronary vasospasm in the patients with coronary vasospastic angina. We have postulated that the peripheral leukocyte count and the differential count are associated with vasospastic angina.Methods144 patients who underwent intracoronary ergonovine provocation testing between January 2002 and December 2004 were divided into two groups: Group I (72 patients with provoked spasm, mean age: 54.8±10.7 years, males: 75%) and Group II (72 without spasm, mean age: 55.3±10.2 years, males: 35%). Blood sampling was done to measure the lipid profiles and inflammatory markers, including the high sensitive C-reactive protein (hsCRP) levels and the monocyte counts. We compared the angiographic findings and laboratory data between the two groups.ResultsThere were no significant differences in the levels of serum lipid and hsCRP between the two groups. The white blood cell count and the monocyte count were higher in Group I than with Group II (7496.4±2622.28 vs. 6703.2±1768.37/mm3, respectively, p=0.035; 627.5±270.70 vs. 426.9±205.76/mm3, respectively, p<0.001). Gensini's score was higher in Group I than in Group II (2.2±2.88 vs. 0.5±1.03, respectively, p<0.001). Multivariate analysis showed that the monocyte count and Gensini's score were independent factors affecting coronary spasm (p=0.047 and p=0.018, respectively). According to a receiver operating characteristics curve analysis, the area under the curve of the monocyte count was 0.738, that of the neutrophil count was 0.577 and that of the WBC count was 0.572. The cut-off value of the monocyte count was 530/mm3; the sensitivity and specificity of this cut-off value were 64% and 76%, respectively.ConclusionsThe peripheral monocyte count is an independent marker for predicting vasospastic angina in the patients with resting chest pain and insignificant coronary artery stenosis.

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Section: Discussionmentioning

confidence: 99%

An Increased Monocyte Count Predicts Coronary Artery Spasm in Patients with Resting Chest Pain and Insignificant Coronary Artery Stenosis

Yun

Park

et al. 2006

Korean J Intern Med

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“…12,13) The mechanism of coronary vasospasm includes hypersensitivity to endothelium derived factors, platelet derived vasoactive substances, and autonomic nervous tone. 14,15) The basal coronary tone is related to the regulation of vascular smooth muscle tension by local endothelium derived factors, humoral factors, and parasympathetic nervous tone. 16,17) Thus, similar factors may play a role in both vasospasm and the basal coronary tone, and vascular endothelial dysfunction in particular can be a critical factor.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Responsiveness to Ergonovine Provocation in Patients Without Vasospatic Angina A Quantitative Coronary Angiography Analysis

Yun

Shin

et al. 2011

Int. Heart J.

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Even patients without vasospastic angina show vasoconstriction after intracoronary ergonovine administration. We evaluated the determinants of coronary artery responsiveness to ergonovine in such patients.In 165 patients with no provoked electrocardiographic changes or ischemic chest pain during an intracoronary ergonovine test, total cholesterol, triglycerides (TG), high density lipoprotein cholesterol (HDL), and low density lipoprotein cholesterol (LDL) were correlated with the arterial luminal diameters before and after ergonovine infusion and after nitroglycerin injection by quantitative coronary angiography analysis.The mean and maximal basal tone (ie, percent change between baseline luminal diameter and diameter after nitroglycerin) were 7.0 ± 9.9% and 27.9 ± 10.8%, respectively. The mean and maximal responsiveness to ergonovine (ie, percent change between minimal diameter during ergonovine infusion and diameter after nitroglycerin) were 30.3 ± 13.6% and 52.7 ± 16.0%, respectively. The TG level (r = 0.191, P = 0.016) and TG/HDL ratio (r = 0.182, P = 0.021) were positively correlated with the basal tone, whereas LDL level (r = 0.155, P = 0.048) and LDL/HDL ratio (r = 0.172, P = 0.030) were positively correlated with the responsiveness to ergonovine. By multivariate analysis, LDL level, LDL/HDL ratio, and smoking were independent predictors of more than 50% responsiveness to ergonovine.Serum lipid profile and smoking influence the basal tone and responsiveness to ergonovine of coronary artery in patients without vaospastic angina.

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“…These alterations suggest different degrees of WBC activation and reflect the severity of the existing inflammatory process which is responsible for the atherosclerotic plaque, which can lead to coronary artery spasm [22] or contribute to coronary artery occlusion [27]. Episodic coronary spasm has a circadian variation with an increased prevalence of anginal attacks from midnight to early morning [28]. Therefore, we performed the FMD study early in the morning between 06:00 h and 08:00 h. Coronary spasm often occurs early in the morning and it is possible that FMD in VA patients may be minimal early in the morning.…”

Section: Figurementioning

confidence: 99%

Endothelial dysfunction, increased carotid artery intima-media thickness and pulse wave velocity, and increased level of inflammatory markers are associated with variant angina

Cho

Jeong

Park

et al. 2009

Journal of Cardiology

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Alterations of Autonomic Nervous Activity Associated with Spontaneous Coronary Spasm in Patients with Variant Angina

Cited by 4 publications

References 14 publications

An Increased Monocyte Count Predicts Coronary Artery Spasm in Patients with Resting Chest Pain and Insignificant Coronary Artery Stenosis

An Increased Monocyte Count Predicts Coronary Artery Spasm in Patients with Resting Chest Pain and Insignificant Coronary Artery Stenosis

Coronary Artery Responsiveness to Ergonovine Provocation in Patients Without Vasospatic Angina A Quantitative Coronary Angiography Analysis

Endothelial dysfunction, increased carotid artery intima-media thickness and pulse wave velocity, and increased level of inflammatory markers are associated with variant angina

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