Vasospastic angina: pathophysiology and clinical significance
The review discusses an analysis of the literature on various aspects of the pathogenesis, diagnosis and treatment of vasospastic angina (VA). Data on the prevalence of coronary artery spasm (CAS) in various populations, as well as risk factors and triggers, are presented. We considered pathophysiol...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | Russian |
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«SILICEA-POLIGRAF» LLC
2020-03-01
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| Series: | Кардиоваскулярная терапия и профилактика |
| Subjects: | |
| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/2391 |
| _version_ | 1797882381814726656 |
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| author | B. I. Geltser M. M. Tsivanyuk V. N. Kotelnikov R. S. Karpov |
| author_facet | B. I. Geltser M. M. Tsivanyuk V. N. Kotelnikov R. S. Karpov |
| author_sort | B. I. Geltser |
| collection | DOAJ |
| description | The review discusses an analysis of the literature on various aspects of the pathogenesis, diagnosis and treatment of vasospastic angina (VA). Data on the prevalence of coronary artery spasm (CAS) in various populations, as well as risk factors and triggers, are presented. We considered pathophysiological mechanisms of CAS, including hyperreactivity of coronary smooth muscle cells, endothelial dysfunction, nonspecific inflammation, oxidative stress, magnesium deficiency, autonomic imbalance, etc. The relationship of CAS with coronary atherosclerosis and thrombosis is emphasized. Modern recommendations for the diagnosis and treatment of VA are presented. Invasive verification of CAS is performed by pharmacological provocation tests with certain contraindications. Calcium antagonists and their combination with long-acting nitrates play a key role in the treatment of VA. Medications with a prospect for use in VA are Rho-kinase inhibitors, ATP-sensitive potassium channel activators, alpha-1 blockers. The management of patients with refractory VA and the prospects for endovascular treatment are discussed. It was noted that patients with multi-vessel VA are more likely to develop life-threatening arrhythmias and sudden death. |
| first_indexed | 2024-04-10T03:34:53Z |
| format | Article |
| id | doaj.art-38e578182b4147e8adf076a8a66f2767 |
| institution | Directory Open Access Journal |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| last_indexed | 2024-04-10T03:34:53Z |
| publishDate | 2020-03-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
| record_format | Article |
| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj.art-38e578182b4147e8adf076a8a66f27672023-03-13T07:23:28Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252020-03-011919910510.15829/1728-8800-2020-1-23912059Vasospastic angina: pathophysiology and clinical significanceB. I. Geltser0M. M. Tsivanyuk1V. N. Kotelnikov2R. S. Karpov3ФГАОУ ВО Дальневосточный федеральный университетФГАОУ ВО Дальневосточный федеральный университет; КГБУЗ Владивостокская клиническая больница № 1ФГАОУ ВО Дальневосточный федеральный университетФГБНУ Томский национальный исследовательский медицинский центр Российской академии наукThe review discusses an analysis of the literature on various aspects of the pathogenesis, diagnosis and treatment of vasospastic angina (VA). Data on the prevalence of coronary artery spasm (CAS) in various populations, as well as risk factors and triggers, are presented. We considered pathophysiological mechanisms of CAS, including hyperreactivity of coronary smooth muscle cells, endothelial dysfunction, nonspecific inflammation, oxidative stress, magnesium deficiency, autonomic imbalance, etc. The relationship of CAS with coronary atherosclerosis and thrombosis is emphasized. Modern recommendations for the diagnosis and treatment of VA are presented. Invasive verification of CAS is performed by pharmacological provocation tests with certain contraindications. Calcium antagonists and their combination with long-acting nitrates play a key role in the treatment of VA. Medications with a prospect for use in VA are Rho-kinase inhibitors, ATP-sensitive potassium channel activators, alpha-1 blockers. The management of patients with refractory VA and the prospects for endovascular treatment are discussed. It was noted that patients with multi-vessel VA are more likely to develop life-threatening arrhythmias and sudden death.https://cardiovascular.elpub.ru/jour/article/view/2391вазоспастическая стенокардияпатофизиологические механизмыалгоритмы диагностики и лечения |
| spellingShingle | B. I. Geltser M. M. Tsivanyuk V. N. Kotelnikov R. S. Karpov Vasospastic angina: pathophysiology and clinical significance Кардиоваскулярная терапия и профилактика вазоспастическая стенокардия патофизиологические механизмы алгоритмы диагностики и лечения |
| title | Vasospastic angina: pathophysiology and clinical significance |
| title_full | Vasospastic angina: pathophysiology and clinical significance |
| title_fullStr | Vasospastic angina: pathophysiology and clinical significance |
| title_full_unstemmed | Vasospastic angina: pathophysiology and clinical significance |
| title_short | Vasospastic angina: pathophysiology and clinical significance |
| title_sort | vasospastic angina pathophysiology and clinical significance |
| topic | вазоспастическая стенокардия патофизиологические механизмы алгоритмы диагностики и лечения |
| url | https://cardiovascular.elpub.ru/jour/article/view/2391 |
| work_keys_str_mv | AT bigeltser vasospasticanginapathophysiologyandclinicalsignificance AT mmtsivanyuk vasospasticanginapathophysiologyandclinicalsignificance AT vnkotelnikov vasospasticanginapathophysiologyandclinicalsignificance AT rskarpov vasospasticanginapathophysiologyandclinicalsignificance |