title: Peripheral arterial function and coronary microvascular function in patients with variant angina.
abstract: OBJECTIVE
  In this study, we assessed whether any abnormalities in coronary microvascular and peripheral vasodilator functions are present in patients with variant angina (VA) caused by epicardial coronary artery spasm (CAS).
  
  
  METHODS
  We studied 23 patients with VA (i.e. angina at rest, ST-segment elevation during angina attacks and documented occlusive CAS at angiography) and 18 matched healthy controls. Endothelium-dependent and -independent coronary microvascular function was assessed by measuring coronary blood flow (CBF) response to adenosine and the cold pressor test (CPT) in the left anterior descending artery by transthoracic Doppler echocardiography. Systemic endothelium-dependent and -independent arterial dilator function was assessed by measuring brachial flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD), respectively.
  
  
  RESULTS
  In VA patients, CBF responses to both adenosine (1.71 ± 0.25 vs. 2.97 ± 0.80, p < 0.01) and CPT (1.68 ± 0.23 vs. 2.58 ± 0.60, p < 0.01) were reduced compared to controls. Brachial FMD was also lower (3.87 ± 2.06 vs. 8.51 ± 2.95%, p < 0.01), but NMD was higher (16.7 ± 1.8 vs. 11.9 ± 1.4%, p < 0.01) in patients compared to controls. Differences were independent of the presence of coronary atherosclerotic lesions at angiography.
  
  
  CONCLUSIONS
  Our data show that patients with VA have a generalized vascular dysfunction that involves both peripheral artery vessels and coronary microcirculation.
authors: Department of Cardiological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
authors: Rossella
authors: R
authors: Parrinello
authors: Alfonso
authors: A
authors: Sestito
authors: Antonino
authors: A
authors: Di Franco
authors: Giulio
authors: G
authors: Russo
authors: Angelo
authors: A
authors: Villano
authors: Stefano
authors: S
authors: Figliozzi
authors: Roberto
authors: R
authors: Nerla
authors: Pierpaolo
authors: P
authors: Tarzia
authors: Alessandra
authors: A
authors: Stazi
authors: Gaetano A
authors: GA
authors: Lanza
authors: Filippo
authors: F
authors: Crea
mesh_terms: D000368:Aged; D000788:Angina Pectoris, Variant / Q000209:etiology / Q000503:physiopathology*; D001916:Brachial Artery / Q000503:physiopathology*; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000502:physiology*; D003329:Coronary Vasospasm / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology*; D014664:Vasodilation / Q000502:physiology