title: Repeated epicardial coronary artery endothelial injuries lead to a global spontaneous coronary artery spasm.
abstract: OBJECTIVE
  This study was conducted to develop a spontaneous coronary spasm model.
  
  
  METHODS
  Balloon endothelial denudation was carried out in the epicardial left anterior descending coronary artery (LAD) every 2 weeks, for a total of four times, in 12 pigs. Changes in the denuded site diameter and LAD blood flow caused by acetylcholine or serotonin were assessed before each denudation and at week 8. Blood pressure, electrocardiogram (ECG) from the LAD area and LAD blood flow were monitored continuously in conscious and unrestrained pigs.
  
  
  RESULTS
  Spontaneous ECG ST depression with a decrease in LAD blood flow appeared at around 2 weeks. In accordance with this, 0.5 microg/kg acetylcholine induced similar ECG and LAD blood flow changes without denuded site narrowing, suggesting microvascular spasm. Thereafter, ECG ST depression or elevation by serotonin via a denuded site spasm was found after 6 weeks and spontaneous ECG ST changes due to epicardial coronary artery spasm were observed.
  
  
  CONCLUSIONS
  Epicardial coronary artery endothelial injury may induce spontaneous vasospasticity in the downstream coronary microvessels as well as in the denuded portion, suggesting functional abnormality through the entire coronary arterial tree.
authors.affiliation: First Department of Internal Medicine, Fukushima Medical University, Japan.
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Misturu
authors.initials: M
authors.lastname: Muto
authors.forename: Taku
authors.initials: T
authors.lastname: Osugi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Aikawa
authors.forename: Ken
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Futoshi
authors.initials: F
authors.lastname: Onogi
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Maehara
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishibashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Maruyama
mesh_terms: D000109:Acetylcholine; D000704:Analysis of Variance; D000818:Animals; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D003329:Coronary Vasospasm / Q000209:etiology*; D003331:Coronary Vessels / Q000293:injuries* / Q000503:physiopathology; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000293:injuries / Q000503:physiopathology; D008833:Microcirculation / Q000503:physiopathology; D010496:Pericardium; D012701:Serotonin; D013552:Swine
chemical_list: D012701:Serotonin; D000109:Acetylcholine