Disease relevance of Microvascular Angina

• Angiotensin-converting enzyme inhibition lessens exercise-induced ischemia in patients with syndrome X and microvascular angina, probably by a direct modulation of coronary microvascular tone, which results in an increased myocardial oxygen supply [1].
• AIMS: To assess platelet aggregability at rest and in response to exercise in patients with cardiac syndrome X (anginal chest pain, ST-segment depression on exercise, angiographically normal coronary arteries) [2].
• OBJECTIVE: The cardiac syndrome X is described as the triad of angina pectoris, a positive exercise test for myocardial ischemia, and angiographically smooth coronary arteries [3].
• The role of nitric oxide and the effects of L-arginine in the pathogenesis and treatment of hypertension and microvascular angina need to be elucidated [4].
• Angina pectoris is a pain syndrome caused by coronary arteriosclerosis but also by a number of other disorders, including microvascular angina, gastroesophageal reflux (GER), and esophageal dysmotility [5].

High impact information on Microvascular Angina

• METHODS AND RESULTS: The effect of intracoronary infusion of L-arginine (50 mg/mm) on acetylcholine-induced coronary vasomotion was studied in eight patients with microvascular angina and eight control subjects [6].
• Five of 36 patients with microvascular angina had a basal FEV1 of less than 70% of that predicted and did not receive methacholine [7].
• METHODS: In 11 women (mean [+/-SD] age 60.1 +/- 7.8 years) with microvascular angina (anginal pain, normal epicardial coronary arteries, positive exercise stress test), endothelium-dependent vasodilation was assessed in the brachial artery by measuring the change in brachial artery diameter in response to hyperemic flow [8].
• CONCLUSIONS: Statin therapy resulted in beneficial effects on both exercise induced ischaemia and FMD in cardiac syndrome-X [9].
• Given the high prevalence of peri- and post-menopausal women in cardiac syndrome X, it has been hypothesized that oestrogen deficiency may play a major role in the pathogenesis of this condition [10].

Chemical compound and disease context of Microvascular Angina

• Effects of angiotensin-converting enzyme inhibition on exercise-induced angina and ST segment depression in patients with microvascular angina [1].
• Impaired nocturnal synthesis of melatonin in patients with cardiac syndrome X [11].
• MATERIALS AND METHODS: We performed a Frequently Sampled Intravenous Glucose Tolerance Test (0.33 g kg(-1) b.w.) in 10 normal weight and normotensive patients with microvascular angina, with normal glucose tolerance and normal plasma lipids [12].
• Patients with cardiac Syndrome X are hypersensitive to potential pain stimuli, including adenosine [13].
• Total cholesterol, LDL-cholesterol and apolipoprotein B levels in microvascular angina patients (235 +/- 46 mg dL-1, 135 +/- 33 mg dL-1 and 146 +/- 32 mg dL-1 respectively) were significantly higher than in control subjects (204 +/- 40 mg dL-1, 116 +/- 35 mg dL-1 and 129 +/- 29 mg dL-1 respectively, P < 0.01) [14].

Biological context of Microvascular Angina

• Insulin resistance is increased by transdermal estrogen therapy in postmenopausal women with cardiac syndrome X [15].

Anatomical context of Microvascular Angina

• Patients may have anginal chest pain with inflation of an esophageal balloon, and patients with microvascular angina may have pain with catheter manipulation in the right atrium [5].
• Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): diagnosis by combined atrial pacing and thallium 201 imaging--a case report [16].
• Ultrastructural changes of blood capillaries in patients with microvascular angina, hypertrophic cardiomyopathy, and dilated cardiomyopathy [17].

Gene context of Microvascular Angina

• Vasospastic angina and microvascular angina are differentially influenced by PON1 A632G polymorphism in the Japanese [18].
• Decreased serum osteoprotegerin levels in patients with cardiac syndrome X [19].
• The prevalence of the NOS G(298) allele was higher in the hypertensive group with microvascular angina (documented by MPI) than it was among the control participants (P<.005) [20].
• The linkages between HPN, microvascular angina and eNOS gene polymorphism were investigated [20].
• RESULTS: The baseline MBF was comparable among NIDDM patients with microvascular angina, NIDDM patients with CAD, and control subjects [21].

Analytical, diagnostic and therapeutic context of Microvascular Angina

• In this paper we review the evidence that angina and 'ischaemic' ST depression can be caused by inappropriate constriction of small coronary artery vessels in patients with microvascular angina (i.e. anginal chest pain with angiographically normal coronary arteries) [22].
• This randomized, double-blind, placebo-controlled, crossover study was conducted to evaluate the effect of nicorandil (a nitrate-potassium channel opener) therapy on exercise-induced myocardial ischemia and cardiac autonomic activity in 13 patients with microvascular angina [23].
• The possible algogenic effects of elevated serum endothelin levels in cardiac syndrome X were investigated in a case-control study that examined somatic pain perception in the forearm during submaximal effort tourniquet and cold immersion tests [24].
• Adenosine stress echocardiography was performed in nine patients (58 (+/-3) years, eight women) with documented microvascular angina [25].

References