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Review
. 2020 Apr 6:15:e12.
doi: 10.15420/ecr.2019.20. eCollection 2020 Feb.

Coronary Artery Spasm: The Interplay Between Endothelial Dysfunction and Vascular Smooth Muscle Cell Hyperreactivity

Astrid Hubert  1 , Andreas Seitz  1 , Valeria Martínez Pereyra  1 , Raffi Bekeredjian  1 , Udo Sechtem  1 , Peter Ong  1
Affiliations
Review

Coronary Artery Spasm: The Interplay Between Endothelial Dysfunction and Vascular Smooth Muscle Cell Hyperreactivity

Astrid Hubert et al. Eur Cardiol. .

Abstract

Patients with angina pectoris, the cardinal symptom of myocardial ischaemia, yet without significant flow-limiting epicardial artery stenosis represent a diagnostic and therapeutic challenge. Coronary artery spasm (CAS) is an established cause for anginal chest pain in patients with angiographically unobstructed coronary arteries. CAS may occur at the epicardial level and/or in the microvasculature. Although the underlying pathophysiological mechanisms of CAS are still largely unclear, endothelial dysfunction and vascular smooth muscle cell (VSMC) hyperreactivity seem to be involved as major players, although their contribution to induce CAS is still seen as controversial. This article will look at the role and possible mechanistic interplay between an impaired endothelial and VSMC function in the pathogenesis of CAS.

Keywords: Coronary artery spasm; angina pectoris; endothelial dysfunction; unobstructed coronary arteries; vascular smooth muscle cell hyperreactivity.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Proposed Mechanistic Interplay Between Endothelial Dysfunction and Vascular Smooth Muscle Cell Hyperreactivity in the Pathogenesis of Coronary Artery Spasm
See this image and copyright information in PMC

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