Clinical determinants of acetylcholine-induced coronary artery spasm in Australian patients

Fiore, David Di; Zeitz, Chris; Arstall, Margaret; Rajendran, S; Sheikh, A.; Beltrame, John F.

doi:10.1016/j.ijcard.2015.05.058

Cited by 16 publications

(9 citation statements)

References 8 publications

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“…In the present study, we demonstrated a higher prevalence of epicardial vasospasm in men vs. women, which is in line with currently available literature. Several studies reported a higher prevalence of epicardial vasospasm among men compared with women in selected populations undergoing ACH provocation testing ( 18 , 20 , 21 ). A possible explanation could be a higher extend of underlying (nonobstructive) atherosclerosis ( 18 , 20 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported a higher prevalence of epicardial vasospasm among men compared with women in selected populations undergoing ACH provocation testing ( 18 , 20 , 21 ). A possible explanation could be a higher extend of underlying (nonobstructive) atherosclerosis ( 18 , 20 , 22 ). Despite discordant reports in the last decades, earlier studies using intracoronary imaging suggest that epicardial vasospasm may be associated with mild atherosclerosis ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Next, adenosine (typically 140 μg/kg/min) was administered intravenously to induce steady state maximal hyperemia—and thereby minimal microvascular resistance—and at least three more injections of room temperature saline were recorded and averaged to determine the hyperemic Tmn. The coronary flow reserve (CFR) was determined by dividing the average resting Tmn by the average hyperemic Tmn ( 18 ). Microvascular resistance, measured as the index of microvascular resistance (IMR), was calculated as the distal pressure (Pd) at maximal hyperemia multiplied by hyperemic Tmn ( 19 , 20 ).…”

Section: Methodsmentioning

confidence: 99%

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Sex Differences in Coronary Function Test Results in Patient With Angina and Nonobstructive Disease

Jansen

Elias‐Smale

Oord

et al. 2021

Front. Cardiovasc. Med.

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Introduction: Invasive coronary function testing (CFT) has become the recommended diagnostic tool to assess the various endotypes of coronary vasomotor dysfunction in patients with angina and no obstructive coronary artery disease (ANOCA), which has implications for therapy and prognosis. Although the expanding performance of CFT is leading to increased knowledge of coronary vasomotor dysfunction, little is known about sex-related differences in the results of comprehensive CFT.Methods: We conducted a prospective study of all consecutive patients with ANOCA that underwent clinically indicated CFT in a tertiary interventional from February 2019 to February 2021. CFT consisted of acetylcholine testing to diagnose epicardial or microvascular spasm, and adenosine testing to diagnose CMD. CMD was defined as an index of microvascular resistance (IMR) ≥ 25 and/or coronary flow reserve (CFR) < 2.0.Results: In total, 228 women and 38 men underwent CFT. No differences in traditional risk factors were seen, but women had a higher prevalence of migraine (45 vs. 14%, p = 0.001). Men more often had a history of percutaneous coronary intervention (12 vs. 49%, p = 0.001). We found no difference in clinical presentation. Coronary vasomotor dysfunction was present in 95% of men and 88% of women (p = 0.25), but males show more often epicardial spasm and less microvascular spasm than women (63 vs. 42% and 29 vs. 40% respectively, p = 0.039). Impaired CFR was more prevalent among females (6 vs 20%, p = 0.033). IMR [median of 23 (15–32) vs. 19 (13–25), p = 0.08] did not differ between the sexes.Conclusion: Men undergoing CFT show a comparable prevalence of coronary vascular dysfunction as women. However, men have a higher prevalence of epicardial spasm and a lower prevalence of microvascular spasm compared with women. An impaired CFR was more often present in women, with an equally impairment of IMR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Sex Differences in Coronary Function Test Results in Patient With Angina and Nonobstructive Disease

Jansen

Elias‐Smale

Oord

et al. 2021

Front. Cardiovasc. Med.

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“…Firstly, vascular smooth muscle cell is hyper‐reactive to vasoconstrictors like ET‐1; and secondly, enough vasoconstrictors exist locally to induce vasospasm . Blockage of the ERK1/2 signal pathways abolished smoke particle‐induced ET A receptor up‐regulation and significantly decreased ET A receptor‐mediated contractile response of the smooth muscle cells, suggesting that the ERK1/2 signal pathways may play a key role in smoke‐associated vasospasm such as coronary artery spasm . A recent clinical study showed that sildenafil inhibited pulmonary artery endothelial and smooth muscle cell to mesenchymal transition by inhibition of ERK1/2 and SMAD3 phosphorylation .…”

Section: Discussionmentioning

confidence: 99%

“…Cigarette smoking strongly increases the risk of the development of peripheral arterial disease, coronary heart disease and stroke . In particular, smoking is the strongest risk factor for inducing coronary artery vasospasm , as many other conventional risk factors for atherosclerosis do not appear to be responsible for inducing vasospastic angina . In addition, independent of other cardiovascular risk factors, passive smoking per se increases the risk of cardiovascular disease by 25–30% .…”

mentioning

confidence: 99%

Lipid‐soluble Cigarette Smoke Particles Induced Vascular Endothelin Type A Receptor Up‐Regulation through Activation of ERK1/2 Signal Pathways

Zhang

Edvinsson

et al. 2017

Basic Clin Pharma Tox

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Abnormal contraction of vessels termed 'vasospasm' is associated with various cardiovascular diseases. Smoking is a well-known risk factor that increases vasospasm. However, the molecular mechanisms by which smoking leads to vasospasm and cardiovascular disease are not fully understood. This study was designed to examine whether DMSO-extracted cigarette smoke particles (DSP) could induce up-regulation of vascular endothelin type A (ET ) receptors, and whether ET receptor is up-regulated through activation of extracellular regulated protein kinases 1 and 2 (ERK1/2) signal pathways. Mesenteric arterial segments from rats were cultured in the presence of DSP, water-extracted cigarette smoke particles (WSP) or equivalent concentration of nicotine for up to 24 hr. The results showed that DSP, but not WSP or nicotine, induced ET receptor up-regulation with increased ET receptor-mediated contraction (myograph, p < 0.001). Simultaneously, the expression of ET receptor mRNA (real-time PCR, p < 0.001) and protein (immunohistochemistry) were enhanced in the smooth muscle cells, suggesting that the lipid-soluble substances contained in cigarette smoke were responsible for the effects of DSP. Actinomycin D (a general transcriptional inhibitor) decreased ET receptor mRNA expression and attenuated receptor-mediated contraction (p < 0.001), while DSP accelerated ET receptor mRNA degradation (p < 0.01) and promoted the translation of ET receptor mRNA into protein. Furthermore, the up-regulation of ET receptors was significantly attenuated by inhibition of ERK1/2 signal pathways (p < 0.001). In conclusion, DSP most likely activate ERK1/2 signal pathway-mediated transcriptional and post-transcriptional (translational) mechanisms that lead to vascular ET receptor up-regulation, which might contribute to vasospasm and the development of smoking-associated cardiovascular diseases.

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The Association of Obstructive Sleep Apnea in Ischemia with No Obstructive Coronary Artery Disease – A Pilot Study

Ooi

Rajendran

Munawar

et al. 2023

Current Problems in Cardiology

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Clinical determinants of acetylcholine-induced coronary artery spasm in Australian patients

Cited by 16 publications

References 8 publications

Sex Differences in Coronary Function Test Results in Patient With Angina and Nonobstructive Disease

Sex Differences in Coronary Function Test Results in Patient With Angina and Nonobstructive Disease

Lipid‐soluble Cigarette Smoke Particles Induced Vascular Endothelin Type A Receptor Up‐Regulation through Activation of ERK1/2 Signal Pathways

The Association of Obstructive Sleep Apnea in Ischemia with No Obstructive Coronary Artery Disease – A Pilot Study

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