Structural and functional abnormality of systemic microvessels in cardiac syndrome X
Autor: | F Biagi, M. Di Renzo, Fulvio Bruni, Andrea Camarri, M Servi, Alberto Auteri, Marcello Pastorelli, D Bischeri, Luca Puccetti, A. L. Pasqui, Alberto Palazzuoli |
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Rok vydání: | 2005 |
Předmět: |
Angina Pectoris
Variant Male Pathology medicine.medical_specialty Endothelium Endocrinology Diabetes and Metabolism Medicine (miscellaneous) Inflammation Chest pain Fibrinogen Angina Pectoris Microscopic Angioscopy Microcirculation Arteriole Coronary Circulation medicine.artery Cardiac syndrome X medicine Humans Microscopy Video Nutrition and Dietetics Venule business.industry Syndrome Middle Aged medicine.disease Coronary Vessels medicine.anatomical_structure Case-Control Studies Female medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
Zdroj: | Europe PubMed Central |
ISSN: | 0939-4753 |
Popis: | Summary Background and aim Microvascular damage of coronary bed has been considered the main pathogenetic factor of cardiac syndrome X (chest pain, exercise-induced ischemic ST-segment changes and angiographically normal coronary arteries). Previous studies have demonstrated that vascular abnormalities are not confined to the heart, suggesting a peripheral vascular dysfunction. On the hypothesis of a generalized microvascular disturbance in cardiac syndrome X, we performed a morphologic and functional study of systemic microcirculation in patients with syndrome X compared to normal subjects. Methods and results Microvessels were evaluated with intravital videocapillaroscopy (VCP) executed in peripheral and conjunctival observation sites which explore micro and paramicrocirculation; biohumoral study included markers of inflammation and of endothelial function, coagulative–fibrinolytic system and lipid metabolism. Videocapillaroscopy showed several morphologic changes (present in high percent of patients with syndrome X and not in controls) and significant quantitative alterations (capillary density, granular flow score, alterations of vessel profile, length of capillary loop branches and of arteriole/venule diameter) which indicated a severe alteration of whole vessel structure and an important rearrangement of microvascular disposition. In a similar way, the humoral study showed some significant changes of endothelial (vWF, ICAM-1, E-sel, PAI-1), inflammatory (C-reactive protein (CRP), fibrinogen) and metabolic factors (HDL-chol) which are commonly associated with inflammatory response. Conclusions We conclude that patients with cardiac syndrome X exhibited some structural and functional alterations of systemic microvasculature; the pattern is similar to that detected in systemic inflammatory diseases and suggests a vascular lesion of inflammatory type. The same changes could be operating also in coronary microvessels of patients with syndrome X. |
Databáze: | OpenAIRE |
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