Coronary Adventitial and Perivascular Adipose Tissue Inflammation in Patients With Vasospastic Angina

Ohyama, Kazuma; Matsumoto, Yasuharu; Takanami, Kentaro; Ota, Hideki; Nishimiya, Kensuke; Sugisawa, Jun; Tsuchiya, Satoshi; Amamizu, Hirokazu; Uzuka, Hironori; Suda, Akira; Shindo, Tomohiko; Kikuchi, Yoku; Hao, Kun; Tsuburaya, Ryuji; Takahashi, Jun; Miyata, Satoshi; Sakata, Yasuhiko; Takase, Kei; Shimokawa, Hiroaki

doi:10.1016/j.jacc.2017.11.046

Cited by 142 publications

(104 citation statements)

References 33 publications

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“…Recently, Ohyama et al demonstrated that the coronary perivascular TBR of adipose tissue was significantly increased in patients with vasospastic angina, as compared to controls (1.04 ± 0.03 vs. 0.85 ± 0.04, P b 0.01), and it was markedly decreased after long-term treatment with calcium-channel blockers [24]. These findings indicate that FDG PET/ CT could be useful for assessing disease activity even in low-grade inflammatory diseases.…”

Section: Follow-up Studiesmentioning

confidence: 98%

Positron emission tomography/computed tomography detection of increased 18F-fluorodeoxyglucose uptake in the cardiac atria of patients with atrial fibrillation

Watanabe

Miyagawa

Uetani

et al. 2019

International Journal of Cardiology

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Background: Direct evidence of inflammatory activity in the atria of patients with atrial fibrillation (AF) is scarce. We assessed the capability of positron-emission tomography/computed tomography (PET/CT) to diagnose AF based on fluorodeoxyglucose (FDG) uptake in the atrial wall. Methods and results: Among 8233 patients who underwent FDG-PET/CT as work-up for malignancies, we identified 180 consecutive patients with AF (2.2%). Of those, we selected 137 patients who had fasted N12 h before FDG injection for inclusion in the experimental group (88 men and 49 women; age: 72.7 ± 8.9 years). Controls were 62 age-and sex-matched patients without AF. For visual analysis, we used a 4-point grading system. For quantitative analysis, we used the maximum standard uptake value (SUVmax) in the left (LA) and right atrial (RA) myocardium and the target-to-background ratio (TBR) of SUVmax to blood pool activity. The sensitivity, specificity, and positive-predictive value for detecting AF visually were 54.0%, 95.2%, and 96.1%, respectively; for quantitative analysis, the respective values were 65.7%, 75.8%, and 85.7%. Multivariable analysis of 11 clinical and imaging variables showed significant associations with RA SUVmax (odds ratio [OR]: 14.353, P = 0.026) and LA volume (OR: 1.371, P = 0.0001). The RA TBR was greater in cases with persistent AF than in those with paroxysmal AF (P b 0.0001). Pathological investigation of 4 autopsy hearts confirmed infiltration of extravascular macrophages and lymphocytes in the regions with FDG uptake. Conclusions: Higher atrial FDG uptake was associated with AF. PET/CT could be a useful tool for detecting local inflammation in the atria with AF.

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Section: Follow-up Studiesmentioning

confidence: 98%

Positron emission tomography/computed tomography detection of increased 18F-fluorodeoxyglucose uptake in the cardiac atria of patients with atrial fibrillation

Watanabe

Miyagawa

Uetani

et al. 2019

International Journal of Cardiology

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“…Recent study arguing perivascular fat has a role in spasm also support the atherosclerosis could influence the spasm by VSM contraction pathway 15 . But we consider more important factors for spasm is intra-lumen plaque which could more directly affect the luminal circumstances as resulting in flow limitation and obstruction.…”

Section: Discussionmentioning

confidence: 98%

Coronary Plaque Characteristics and Cut-Off Stenosis for Developing Spasm in Patients with Vasospastic Angina

Sim

Baek

2020

Sci Rep

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Coronary plaque distribution, frequency and cut-off value of percent stenosis for developing vasospasm are uncertain in patients with vasospastic angina (VA). We enrolled 2960 patients who received coronary angiography (CAG) and ergonovine provocation test prospectively in 11 university hospitals in Korea. A total of 1836 patients with VA and 867 without VA were included. Plaque and % stenosis were defined as ≥1% luminal narrowing and mean of each segmental stenosis. Overall frequency of plaque and % diameter stenosis was compared among VA-patients with index coronary spasm positive, those with index arterial spasm negative/other arterial spasm positive (INOP) and non-VA patients. Diameter stenosis associated with the spasm positivity was investigated. Overall plaque frequency and % stenosis were higher in VA patients than non-VA patients. Plaque frequency was 27.6% (243/881) in spasm positive at LAD, 16.4% (157/955) in LAD INOP and 12.6% (109/867) in non-VA with statistic difference (P < 0.001). Same trend for higher rate was observed in LCx and RCA. For % stenosis, 36.6 vs 32.4% (p = 0.010) in LAD, 36.1 vs. 28% (p < 0.001) in LCx and 35.3 vs.30.0% (p = 0.047) in RCA, respectively. Diameter stenosis of LAD with spasm positive vs. LAD INOP vs. non-VA were 38.3%, 34.0%, 32% (P = 0.002) with similar pattern in LCx and RCA. By multivariate logistic regression analysis, coronary stenosis of LAD ≥ 35% or LCx ≥35% or RCA ≥ 40% were independent predictor of developing spasm (OR 2.019, 95% CI 1.315–3.100, P = 0.001). In conclusions, spastic coronary artery had more plaque frequency, higher % stenosis than in non-spastic coronary in VA patients. The spasm related and unrelated coronary in VA patients had more plaque than in matched and unmatched coronary arteries in non-VA patients. Coronary stenosis ≥35% in LAD and LCx was an independent predictor of developing spasm.

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“…Исследования на животных продемонстрировали, что имплантация стента с лекарственным покрытием может усиливать воспаление адвентиции КА и вызывать их констрикцию посредством активации ROCK [30]. Доказано, что при ВС эпи-кардиальная и периваскулярная жировая ткань также вовлечены в патогенез неспецифического воспаления [31]. Дисфункция вегетативной нервной системы с преобладанием симпатических влияний в ночные часы может являться одной из причин многососудистого СКА.…”

Section: фр и патофизиологические детерминанты всunclassified

Vasospastic angina: pathophysiology and clinical significance

Гельцер

Tsivanyuk

Kotelnikov

et al. 2020

Cardiovasc Ther Prev

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клиническая больница № 1". Владивосток; 3 ФГБНУ "Томский национальный исследовательский медицинский центр Российской академии наук". Томск, Россия В обзоре представлен анализ научной литературы по различным аспектам патогенеза -диагностики и лечения вазоспастической стенокардии (ВС). Приведены данные о распространенности спазма коронарных артерий (СКА) в различных популяциях, а также факторах риска и провоцирующих триггерах. Рассмотрены патофизиологические механизмы СКА, включающие гиперреактивность гладкомышечных клеток коронарных артерий, эндотелиальную дисфункцию, неспецифическое воспаление, окислительный стресс, дефицит магния, вегетативный дисбаланс и др. Подчеркнута взаимосвязь СКА с коронарным тромбозом и атеросклерозом коронарных артерий. Представлены современные алгоритмы диагностики и лечения ВС. Инвазивную верификацию СКА осуществляют путем проведения провокационных фармакологических тестов, которые имеют противопоказания. Ключевая роль в терапии ВС принадлежит антагонистам кальция и их комбинации с пролонгированными нитратами. К препаратам, имеющим перспективу применения при ВС, относят ингибиторы Rho-киназы, активаторы аденозинтрифосфат-чувствительных К + -каналов, антагонисты альфа-1-адренорецепторов. Обсуждаются особенности ведения больных с рефрактерной ВС и перспективы эндоваскулярного лечения. Отмечено, что больные ВС с многососудистым спазмом имеют более высокую вероятность развития жизнеугрожающих аритмий и внезапной смерти. Ключевые слова: вазоспастическая стенокардия, патофизиологические механизмы, алгоритмы диагностики и лечения.Отношения и деятельность. Работа выполнена при поддержке грантов РФФИ в рамках научных проектов № 18-29-03131, № 19-29-01077.

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Coronary Adventitial and Perivascular Adipose Tissue Inflammation in Patients With Vasospastic Angina

Cited by 142 publications

References 33 publications

Positron emission tomography/computed tomography detection of increased 18F-fluorodeoxyglucose uptake in the cardiac atria of patients with atrial fibrillation

Positron emission tomography/computed tomography detection of increased 18F-fluorodeoxyglucose uptake in the cardiac atria of patients with atrial fibrillation

Coronary Plaque Characteristics and Cut-Off Stenosis for Developing Spasm in Patients with Vasospastic Angina

Vasospastic angina: pathophysiology and clinical significance

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