1st Cardiology Department, Hippokration Hospital, Athens University Medical School, Greece.
Curr Pharm Des. 2013;19(9):1593-600.
Atherosclerosis is a chronic disease which mainly represents an inflammatory response in the vessels. Myocardial ischemia manifested by angina pectoris can be either acute or chronic and usually is a result of imbalance between myocardial oxygen supply and myocardial oxygen demand. Chronic stable angina is chest discomfort attributed to myocardial ischemia without the presence of necrosis and is the most common symptom encountered by emergency room physicians. A growing amount of data has shown that endothelial dysfunction, is now considered an important early event in the development of atherosclerosis, while in the absence of angiographically obstructive coronary artery disease, anginal chest pain is often attributed to microvascular coronary dysfunction. Moreover, atheroma formation and in turn, atherosclerotic plaques seem to affect coronary flow, given that multivessel flow-limiting obstructions are observed in patients with chronic coronary syndrome. Morphological changes of diseased arteries related to significant atherosclerosis, such as vascular remodeling may also result in stable angina or claudication. However, several issues with respect to the comprehension of the pathophysiology of the chronic coronary syndrome have not been fully elucidated.
动脉粥样硬化是一种慢性疾病，主要表现为血管的炎症反应。心绞痛表现为心肌缺血，可以是急性的，也可以是慢性的，通常是心肌氧供应和心肌氧需求失衡的结果。慢性稳定型心绞痛是指由于心肌缺血而导致的胸部不适，没有坏死，是急诊科医生最常见的症状。越来越多的数据表明，内皮功能障碍，现在被认为是动脉粥样硬化发展的一个重要早期事件，而在没有血管造影阻塞性冠状动脉疾病的情况下，心绞痛胸痛常归因于微血管冠状动脉功能障碍。此外，动脉粥样斑块的形成，进而影响冠状动脉血流，因为在慢性冠状动脉综合征患者中观察到多支血管限制阻塞。与明显的动脉粥样硬化相关的病变动脉的形态学变化，如血管重构，也可能导致稳定型心绞痛或跛行。然而，关于慢性冠状动脉综合征病理生理学的理解仍存在一些尚未完全阐明的问题。
