Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Curr Pharm Des. 2018;24(25):2906-2910. doi: 10.2174/1381612824666180625150833.
Vasospastic angina is an important cause of chest pain due to coronary artery vasospasm that is related to poor quality of life and can lead to myocardial infarction, arrhythmias and death. Since its first description as "Prinzmetal or variant angina" which was believed to be a focal spam that occurred in non-obstructed epicardial coronary arteries, physician and researchers were gradually confronted with the clinical reality and came to the conclusion that the coronary artery vasospasm was considerably more polymorphic than initially described. Although mechanism leading to vasospastic angina is not completely understood, nowadays the medical community acknowledges that it exhibits a large variability in clinical practice ranging from focal to diffuse epicardial vasospasm. Main proposed mechanisms are impairment of parasympathetic activity, coronary vascular and microvascular dysfunction due to blunted response to nitric oxide endothelium-dependent coronary vasodilatation, increased release of vasoconstricts, and oxidative stress.
血管痉挛性心绞痛是一种重要的胸痛病因，由冠状动脉痉挛引起，与生活质量差有关，并可导致心肌梗死、心律失常和死亡。自从首次被描述为“变异型心绞痛”，即人们认为发生在非阻塞性心外膜冠状动脉的局灶性痉挛以来，医生和研究人员逐渐面对临床现实，并得出结论，即冠状动脉痉挛比最初描述的要复杂得多。尽管导致血管痉挛性心绞痛的机制尚不完全清楚，但如今医学界承认，它在临床上表现出很大的变异性，从局灶性到弥漫性心外膜血管痉挛。主要提出的机制是副交感神经活动受损、冠状动脉血管和微血管功能障碍，导致对一氧化氮依赖的内皮依赖性冠状动脉舒张反应迟钝，血管收缩物质释放增加和氧化应激。
