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Repeated epicardial coronary artery endothelial injuries lead to a global spontaneous coronary artery spasm

2004; Lippincott Williams & Wilkins; Volume: 15; Issue: 3 Linguagem: Inglês

10.1097/00019501-200405000-00002

1473-5830

Shu‐ichi Saitoh, Misturu Muto, Taku Osugi, Kazuhiko Aikawa, Ken Matsumoto, Futoshi Onogi, Kazuhira Maehara, Toshiyuki Ishibashi, Yukio Maruyama,

Cardiac electrophysiology and arrhythmias

This study was conducted to develop a spontaneous coronary spasm model.Balloon endothelial denudation was carried out in the epicardial left anterior descending coronary artery (LAD) every 2 weeks, for a total of four times, in 12 pigs. Changes in the denuded site diameter and LAD blood flow caused by acetylcholine or serotonin were assessed before each denudation and at week 8. Blood pressure, electrocardiogram (ECG) from the LAD area and LAD blood flow were monitored continuously in conscious and unrestrained pigs.Spontaneous ECG ST depression with a decrease in LAD blood flow appeared at around 2 weeks. In accordance with this, 0.5 microg/kg acetylcholine induced similar ECG and LAD blood flow changes without denuded site narrowing, suggesting microvascular spasm. Thereafter, ECG ST depression or elevation by serotonin via a denuded site spasm was found after 6 weeks and spontaneous ECG ST changes due to epicardial coronary artery spasm were observed.Epicardial coronary artery endothelial injury may induce spontaneous vasospasticity in the downstream coronary microvessels as well as in the denuded portion, suggesting functional abnormality through the entire coronary arterial tree.