How to study the effects of inflammation on coronary vasomotion and their clinical relevance.
In patients with acute coronary syndromes systemic inflammation is associated with an enhanced vasoreactivity of the culprit coronary lesion. In the complex scenario of the mechanisms responsible for myocardial ischemia, the increased coronary vasoreactivity at the site of the culprit lesion may represent an important pathogenetic factor by limiting coronary blood flow. Systemic inflammation and epicardial vessel vasomotion can be easily measured in humans although, at present, the clinical relevance of such association has not been assessed in clinical trial. In the future, the development of drugs capable of blocking inflammatory molecules, in particular C-reactive protein and endothelin-1, will provide new tools to establish whether inflammation directly contributes to the pathogenesis of the enhanced coronary vasoreactivity and, more importantly, whether these drugs will be capable of positively affecting the prognosis of patients with acute coronary syndromes.
Gaspardone
Achille
A
Division of Cardiac Surgery, Tor Vergata University, Rome, Italy. a_gaspardone@yahoo.com
Tomai
Fabrizio
F
D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000503:physiopathology*; D017202:Myocardial Ischemia / Q000503:physiopathology*; D010496:Pericardium; D014661:Vasoconstriction / Q000502:physiology*
D002097:C-Reactive Protein