Vasospastic angina: pathophysiology and clinical significance
| Autor: | M. M. Tsivanyuk, V. N. Kotelnikov, R. S. Karpov, B. I. Geltser |
|---|---|
| Jazyk: | ruština |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Provocation test Inflammation vasospastic angina 030204 cardiovascular system & hematology Sudden death 03 medical and health sciences 0302 clinical medicine Internal medicine Magnesium deficiency (medicine) pathophysiological mechanisms medicine Diseases of the circulatory (Cardiovascular) system 030212 general & internal medicine Endothelial dysfunction Coronary atherosclerosis business.industry medicine.disease Thrombosis medicine.anatomical_structure diagnostic and treatment algorithms RC666-701 Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Кардиоваскулярная терапия и профилактика, Vol 19, Iss 1, Pp 99-105 (2020) |
| ISSN: | 2619-0125 1728-8800 |
| Popis: | The review discusses an analysis of the literature on various aspects of the pathogenesis, diagnosis and treatment of vasospastic angina (VA). Data on the prevalence of coronary artery spasm (CAS) in various populations, as well as risk factors and triggers, are presented. We considered pathophysiological mechanisms of CAS, including hyperreactivity of coronary smooth muscle cells, endothelial dysfunction, nonspecific inflammation, oxidative stress, magnesium deficiency, autonomic imbalance, etc. The relationship of CAS with coronary atherosclerosis and thrombosis is emphasized. Modern recommendations for the diagnosis and treatment of VA are presented. Invasive verification of CAS is performed by pharmacological provocation tests with certain contraindications. Calcium antagonists and their combination with long-acting nitrates play a key role in the treatment of VA. Medications with a prospect for use in VA are Rho-kinase inhibitors, ATP-sensitive potassium channel activators, alpha-1 blockers. The management of patients with refractory VA and the prospects for endovascular treatment are discussed. It was noted that patients with multi-vessel VA are more likely to develop life-threatening arrhythmias and sudden death. |
| Databáze: | OpenAIRE |
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