Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto City, Japan.
Adv Exp Med Biol. 2019;1193:121-134. doi: 10.1007/978-981-13-6260-6_7.
Coronary spasm plays an important role in the pathogenesis of ischemic heart disease, including angina pectoris, acute myocardial infarction (AMI), silent myocardial ischemia, and sudden death. The prevalence of coronary spasm is higher among East Asians probably due to genetic as well as environmental factors. ALDH2 eliminates toxic aldehydes including 4-hydroxy-2-nonenal (4-HNE) derived from lipid peroxidation and acrolein in tobacco smoking as well as ethanol-derived acetaldehyde and thereby protects tissues and cells from oxidative damage. Deficient variant ALDH2*2 genotype is prevalent among East Asians and is a significant risk factor for both coronary spasm and AMI through accumulation of toxic aldehydes, thereby contributing to oxidative stress, endothelial damage, vasoconstriction, and thrombosis. Toxic aldehydes are thus identified as risk factors to be targeted for the treatment of coronary spasm and AMI.
冠状动脉痉挛在缺血性心脏病的发病机制中起着重要作用，包括心绞痛、急性心肌梗死（AMI）、无症状性心肌缺血和猝死。冠状动脉痉挛在东亚人群中更为常见，这可能与遗传和环境因素有关。ALDH2 消除了包括脂质过氧化和烟草吸烟中的丙烯醛产生的有毒醛（如 4-羟基-2-壬烯醛（4-HNE））以及乙醇衍生的乙醛，从而保护组织和细胞免受氧化损伤。在东亚人群中，ALDH2*2 变异基因型很常见，并且是冠状动脉痉挛和 AMI 的重要危险因素，通过有毒醛的积累，导致氧化应激、内皮损伤、血管收缩和血栓形成。因此，有毒醛被确定为治疗冠状动脉痉挛和 AMI 的目标危险因素。
