Shedding Light on Treatment Options for Coronary Vasomotor Disorders: A Systematic Review.

Microvascular angina Non obstructive coronary artery disease Vasomotor disorders Vasospastic angina

Journal

Cardiovascular drugs and therapy
ISSN: 1573-7241
Titre abrégé: Cardiovasc Drugs Ther
Pays: United States
ID NLM: 8712220

Informations de publication

Date de publication:
09 Jun 2022
Historique:
accepted: 30 05 2022
entrez: 9 6 2022
pubmed: 10 6 2022
medline: 10 6 2022
Statut: aheadofprint

Résumé

Coronary vasomotor dysfunction embraces two specific clinical entities: coronary (micro)vascular spasm and microvascular dysfunction. The clinical manifestations of these entities are respectively called vasospastic angina (VSA) and microvascular angina (MVA). Over the years, these diseases have become more and more prominent and several studies aimed to investigate the best diagnostic and therapeutic strategies. Patients with coronary vasomotor disorders are often undertreated due to the absence of evidence-based guidelines. The purpose of this overview is to illustrate the various therapeutic options available for the optimized management of these patients. A Medline search of full-text articles published in English from 1980 to April 2022 was performed. The main analyzed aspects of vasomotor disorders were treatment options. We also performed research on "Clinicaltrial.gov" for ongoing trials. Coronary (micro)vascular spasm and microvascular dysfunction are clinical entities characterized by high prevalence and clinical representation. Several therapeutic strategies, both innovative and established, are available to optimize treatment and improve the quality of life of these patients.

Identifiants

pubmed: 35678926
doi: 10.1007/s10557-022-07351-x
pii: 10.1007/s10557-022-07351-x
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2022. The Author(s).

Références

Patel MR, Peterson ED, Dai D, et al. low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:886–95.
pubmed: 20220183 pmcid: 3920593 doi: 10.1056/NEJMoa0907272
Jespersen L, Hvelplund A, Abildstrom SZ, et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2012;33:734–44.
pubmed: 21911339 doi: 10.1093/eurheartj/ehr331
Kunadian V, Chieffo A, Camici PG, et al. An EAPCI expert consensus document on ischaemia with non-obstructive coronary arteries in collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group. EuroIntervention. 2021;16:1049–69.
pubmed: 32624456 doi: 10.4244/EIJY20M07_01
Sharaf B, Wood T, Shaw L, et al. Adverse outcomes among women presenting with signs and symptoms of ischemia and no obstructive coronary artery disease: findings from the National Heart, Lung, and Blood Institute–sponsored Women’s Ischemia Syndrome Evaluation (WISE) angiographic core lab. Am Heart J. 2013;166:134–41.
pubmed: 23816032 pmcid: 3703586 doi: 10.1016/j.ahj.2013.04.002
Bing RJ, Hammond MM, Handelsman JC, et al. The measurement of coronary blood flow, oxygen consumption, and efficiency of the left ventricle in man. Am Heart J. 1949;38:1–24.
pubmed: 18153124 doi: 10.1016/0002-8703(49)90788-7
Ong P; Seitz A. the importance of assessing coronary vasomotor function in patients with SIHD with unobstructed coronary arteries. In: Latest in Cardiology. American College of Cardiology. 2020. https://www.acc.org/latest-in-cardiology/articles/2020/12/18/13/54/the-importance-of-assessing-coronary-vasomotor-function-in-patients-with-sihd . Accessed 18 Dec 2020.
Sucato V, Novo G, Saladino A, Evola S, Galassi AR. Coronary microvascular dysfunction. Minerva Cardioangiol. 2020;68.
Suda A, Takahashi J, Hao K, et al. Coronary functional abnormalities in patients with angina and nonobstructive coronary artery disease. J Am Coll Cardiol. 2019;74:2350–60.
pubmed: 31699275 doi: 10.1016/j.jacc.2019.08.1056
Rahman H, Corcoran D, Aetesam-ur-Rahman M, Hoole SP, Berry C, Perera D. Diagnosis of patients with angina and non-obstructive coronary disease in the catheter laboratory. Heart. 2019;105:1536–42.
pubmed: 31366574 doi: 10.1136/heartjnl-2019-315042
Ford TJ, Ong P, Sechtem U, et al. Assessment of vascular dysfunction in patients without obstructive coronary artery disease. JACC Cardiovasc Interv. 2020;13:1847–64.
pubmed: 32819476 pmcid: 7447977 doi: 10.1016/j.jcin.2020.05.052
Konst RE, Meeder JG, Wittekoek ME, et al. Ischemia with no obstructive coronary arteries. Neth Heart J. 2020;28:66–72.
pubmed: 32780334 pmcid: 7419395 doi: 10.1007/s12471-020-01451-9
Beltrame JF, Crea F, Kaski JC, et al. International standardization of diagnostic criteria for vasospastic angina. Eur Heart J. 2017;38(33):2565–8.
pubmed: 26245334
Ong P, Camici PG, Beltrame JF, et al. International standardization of diagnostic criteria for microvascular angina. Int J Cardiol. 2018;250:16–20.
pubmed: 29031990 doi: 10.1016/j.ijcard.2017.08.068
Williams B, Mancia G, Spiering W, ESC Scientific Document Group, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021–104.
pubmed: 30165516 doi: 10.1093/eurheartj/ehy339
Ballantyne CM, Raichlen JS, Nicholls SJ, et al. Effect of rosuvastatin therapy on coronary artery stenoses assessed by quantitative coronary angiography. Circulation. 2008;117:2458–66.
pubmed: 18378607 doi: 10.1161/CIRCULATIONAHA.108.773747
Ridker PM, MacFadyen J, Libby P, Glynn RJ. Relation of baseline high-sensitivity C-reactive protein level to cardiovascular outcomes with rosuvastatin in the justification for use of statins in prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER). Am J Cardiol. 2010;106:204–9.
pubmed: 20599004 doi: 10.1016/j.amjcard.2010.03.018
Bairey Merz CN, Pepine CJ, Shimokawa H, Berry C. Treatment of coronary microvascular dysfunction. Cardiovasc Res. 2020;116:856–70.
pubmed: 32087007 pmcid: 7061279 doi: 10.1093/cvr/cvaa006
Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease. Eur Heart J. 2013;34:2949–3003.
pubmed: 23996286 doi: 10.1093/eurheartj/eht310.P4876
Jansen TPJ, Konst RE, de Vos A, et al. Efficacy of Diltiazem to improve coronary vasomotor dysfunction in angina and nonobstructive coronary arteries (ANOCA): Results of the EDIT-CMD randomized clinical trial. JACC Cardiovasc Imaging. 2022; S1936–878X(22)00177–2
Marinescu MA, Löffler AI, Ouellette M, Smith L, Kramer CM, Bourque JM. Coronary microvascular dysfunction, microvascular angina, and treatment strategies. JACC Cardiovasc Imaging. 2015;8:210–20.
pubmed: 25677893 pmcid: 4384521 doi: 10.1016/j.jcmg.2014.12.008
JCS Joint Working Group. Guidelines for Diagnosis and Treatment of Patients With Vasospastic Angina (Coronary Spastic Angina) (JCS 2013). Circ J. 2014;78:2779–801.
doi: 10.1253/circj.CJ-66-0098
Kim SE, Jo S-H, Han SH, et al. Comparison of calcium-channel blockers for long-term clinical outcomes in patients with vasospastic angina. Korean J Intern Med. 2021;36:124–34.
pubmed: 32088938 doi: 10.3904/kjim.2019.308
Minatoguchi S. Vasospastic angina and ca channel blockers. Curr Hypertens Rev. 2014;9:219–23.
doi: 10.2174/1573402110666140131161338
Fineschi M, Bravi A, Gori T. The, “slow coronary flow” phenomenon: evidence of preserved coronary flow reserve despite increased resting microvascular resistances. Int J Cardiol. 2008;127:358–61.
pubmed: 17651842 doi: 10.1016/j.ijcard.2007.06.010
Mehta HH, Morris M, Fischman DL, et al. The spontaneous coronary slow-flow phenomenon: reversal by intracoronary nicardipine. J Invasive Cardiol. 2019;31:42–5.
pubmed: 30555052
Lim Y, Kim MC, Ahn Y, et al. Prognostic impact of chronic vasodilator therapy in patients with vasospastic angina. J Am Heart Assoc. 2022;11(7):e023776.
pubmed: 35347998 pmcid: 9075493 doi: 10.1161/JAHA.121.023776
Takahashi J, Nihei T, Takagi Y, et al. Prognostic impact of chronic nitrate therapy in patients with vasospastic angina: multicentre registry study of the Japanese coronary spasm association. Eur Heart J. 2015;36:228–37.
pubmed: 25189599 doi: 10.1093/eurheartj/ehu313
Kim CH, Park TK, Cho SW, et al. Impact of different nitrate therapies on long-term clinical outcomes of patients with vasospastic angina: a propensity score-matched analysis. Int J Cardiol. 2018;252:1–5.
pubmed: 29249418 doi: 10.1016/j.ijcard.2017.07.031
Majid PA, DeFeyter PJF, Van der Wall EE, Wardeh R, Roos JP. Molsidomine in the treatment of patients with angina pectoris. N Engl J Med. 1980;302:1–6.
pubmed: 6985697 doi: 10.1056/NEJM198001033020101
Weber S, Kahan A, Pailleret JJ, Guérin F, Degeorges M. Prevention with molsidomine of coronary artery spasm caused by alkalosis. Am Heart J. 1985;109:703–7.
doi: 10.1016/0002-8703(85)90687-8
Shin E-S, Lee J-H, Yoo S-Y, et al. A randomised, multicentre, double blind, placebo controlled trial to evaluate the efficacy and safety of cilostazol in patients with vasospastic angina. Heart. 2014;100:1531–6.
pubmed: 24934484 doi: 10.1136/heartjnl-2014-305986
Robertson RM, Wood AJ, Vaughn WK, Robertson D. Exacerbation of vasotonic angina pectoris by propranolol. Circulation. 1982;65:281–5.
pubmed: 6797752 doi: 10.1161/01.CIR.65.2.281
Tarkin JM, Kaski JC. Vasodilator therapy: nitrates and nicorandil. Cardiovasc Drugs Ther. 2016;30:367–78.
pubmed: 27311574 pmcid: 5658472 doi: 10.1007/s10557-016-6668-z
Tagliamonte E, Rigo F, Cirillo T, et al. Effects of ranolazine on noninvasive coronary flow reserve in patients with myocardial ischemia but without obstructive coronary artery disease. Echocardiography. 2015;32:516–21.
pubmed: 25041234 doi: 10.1111/echo.12674
Villano A, Di Franco A, Nerla R, et al. Effects of ivabradine and ranolazine in patients with microvascular angina pectoris. Am J Cardiol. 2013;112:8–13.
pubmed: 23558043 doi: 10.1016/j.amjcard.2013.02.045
Bairey Merz CN, Handberg EM, Shufelt CL, et al. A randomized, placebo-controlled trial of late Na current inhibition (ranolazine) in coronary microvascular dysfunction (CMD): impact on angina and myocardial perfusion reserve. Eur Heart J. 2016;37:1504–13.
pubmed: 26614823 doi: 10.1093/eurheartj/ehv647
Reis SE, Holubkov R, Smith AJC, et al. Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease: Results from the NHLBI WISE study. Am Heart J. 2001;141:735–41.
pubmed: 11320360 doi: 10.1067/mhj.2001.114198
Pepine CJ, Anderson RD, Sharaf BL, et al. Coronary Microvascular reactivity to adenosine predicts adverse outcome in women evaluated for suspected ischemia. J Am Coll Cardiol. 2010;55:2825–32.
pubmed: 20579539 pmcid: 2898523 doi: 10.1016/j.jacc.2010.01.054
Pauly DF, Johnson BD, Anderson RD, et al. In women with symptoms of cardiac ischemia, nonobstructive coronary arteries, and microvascular dysfunction, angiotensin-converting enzyme inhibition is associated with improved microvascular function: a double-blind randomized study from the National Heart, Lung and Blood Institute Women’s Ischemia Syndrome Evaluation (WISE). Am Heart J. 2011;162(4):678–84.
pubmed: 21982660 pmcid: 3191889 doi: 10.1016/j.ahj.2011.07.011
Traverse JH, Chen YJ, Du R, Bache RJ. Cyclic nucleotide phosphodiesterase type 5 activity limits blood flow to hypoperfused myocardium during exercise. Circulation. 2000;102:2997–3002.
pubmed: 11113052 doi: 10.1161/01.CIR.102.24.2997
Denardo SJ, Wen X, Handberg EM, et al. Effect of phosphodiesterase type 5 inhibition on microvascular coronary dysfunction in women: a women’s ischemia syndrome evaluation (wise) ancillary study. Clin Cardiol. 2011;34:483–7.
pubmed: 21780138 pmcid: 3151010 doi: 10.1002/clc.20935
Weerts J, Mourmans SGJ, Barandiarán Aizpurua A, et al. The Role of systemic microvascular dysfunction in heart failure with preserved ejection fraction. Biomolecules. 2022;12:278.
pubmed: 35204779 pmcid: 8961612 doi: 10.3390/biom12020278
Pieske B, Maggioni AP, Lam CSP, et al. Vericiguat in patients with worsening chronic heart failure and preserved ejection fraction: results of the SOluble guanylate Cyclase stimulatoR in heArT failurE patientS with PRESERVED EF (SOCRATES-PRESERVED) study. Eur Heart J. 2017;38:1119–27.
pubmed: 28369340 pmcid: 5400074 doi: 10.1093/eurheartj/ehw593
Stasch J-P, Hobbs AJ. NO-Independent, haem-dependent soluble guanylate cyclase stimulators. Handb Exp Pharmacol. 2009;191:277–308.
doi: 10.1007/978-3-540-68964-5_13
Bonderman D, Pretsch I, Steringer-Mascherbauer R, et al. Acute hemodynamic effects of riociguat in patients with pulmonary hypertension associated with diastolic heart Failure (DILATE-1). Chest. 2014;146(5):1274–85.
pubmed: 24991733 pmcid: 4219342 doi: 10.1378/chest.14-0106
Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41:407–77.
pubmed: 31504439 doi: 10.1093/eurheartj/ehz425
Skalidis EI, Hamilos MI, Chlouverakis G, Zacharis EA, Vardas PE. Ivabradine improves coronary flow reserve in patients with stable coronary artery disease. Atherosclerosis. 2011;215:160–5.
pubmed: 21183181 doi: 10.1016/j.atherosclerosis.2010.11.035
Camici PG, Gloekler S, Levy BI, et al. Ivabradine in chronic stable angina: effects by and beyond heart rate reduction. Int J Cardiol. 2016;215:1–6.
pubmed: 27104917 doi: 10.1016/j.ijcard.2016.04.001
Shimokawa H, Sunamura S, Satoh K. RhoA/rho-kinase in the cardiovascular system. Circ Res. 2016;118:352–66.
pubmed: 26838319 doi: 10.1161/CIRCRESAHA.115.306532
Ohyama K, Matsumoto Y, Takanami K, et al. Coronary adventitial and perivascular adipose tissue inflammation in patients with vasospastic angina. J Am Coll Cardiol. 2018;71:414–25.
pubmed: 29389358 doi: 10.1016/j.jacc.2017.11.046
Mohri M, Shimokawa H, Hirakawa Y, Masumoto A, Takeshita A. Rho-kinase inhibition with intracoronary fasudil prevents myocardial ischemia in patients with coronary microvascular spasm. J Am Coll Cardiol. Elsevier Masson SAS; 2003;41:15–9.
Halcox JPJ, Nour KRA, Zalos G, Quyyumi AA. Coronary vasodilation and improvement in endothelial dysfunction with endothelin ET A Receptor Blockade. Circ Res. 2001;89:969–76.
pubmed: 11717152 doi: 10.1161/hh2301.100980
Kaski JC, Elliott PM, Salomone O, et al. Concentration of circulating plasma endothelin in patients with angina and normal coronary angiograms. Heart. 1995;74:620–4.
doi: 10.1136/hrt.74.6.620
Johnson NP, Gould KL. Physiology of endothelin in producing myocardial perfusion heterogeneity: a mechanistic study using darusentan and positron emission tomography. J Nucl Cardiol. 2013;20:835–44.
pubmed: 23842710 pmcid: 3779022 doi: 10.1007/s12350-013-9756-5
Reriani M, Raichlin E, Prasad A, et al. Long-term administration of endothelin receptor antagonist improves coronary endothelial function in patients with early atherosclerosis. Circulation. 2010;122:958–66.
pubmed: 20733096 pmcid: 2946239 doi: 10.1161/CIRCULATIONAHA.110.967406
Marchant E, Pichard A, Rodriguez JA, Casanegra P. Acute effect of systemic versus intracoronary dipyridamole on coronary circulation. Am J Cardiol. 1986;57:1401–4.
pubmed: 3717043 doi: 10.1016/0002-9149(86)90226-2
Mandoli GE, Cameli M, Minardi S, Crudele F, Lunghetti S, Mondillo S. Layer-specific strain in dipyridamole stress echo: a new tool for the diagnosis of microvascular angina. Echocardiography. 2018;35:2005–13.
pubmed: 30394569 doi: 10.1111/echo.14180
Michelsen MM, Pena A, Mygind ND, et al. Coronary microvascular dysfunction and myocardial contractile reserve in women with angina and no obstructive coronary artery disease. Echocardiography. 2018;35:196–203.
pubmed: 29222822 doi: 10.1111/echo.13767
Crea F, Gaspardone A, Araujo L, et al. Effects of aminophylline on cardiac function and regional myocardial perfusion: implications regarding its antiischemic action. Am Heart J. 1994;127:817–24.
pubmed: 8154419 doi: 10.1016/0002-8703(94)90548-7
. Elliott PM, Krzyzowska-dickinson K, Calvino R, Hann C. Effect of oral aminophylline in.Heart. 1997;1:523–6.
Yeşildaǧ O, Yazici M, Yilmaz Ö, Uçar R, Saǧkan O. The effect of aminophylline infusion on the exercise capacity in patients with syndrome X. Acta Cardiol. 1999;54(6):335–7.
pubmed: 10672289
Dézsi CA. Trimetazidine in Practice. Am J Ther. 2016;23:e871–9.
pubmed: 25756467 pmcid: 4856171 doi: 10.1097/MJT.0000000000000180
Leonova IA, Boldueva S, Zakharova O, Gaykovaya L. P887Trimetazidine improves symptoms and reduces microvascular dysfunction in patients with microvascular angina. Eur Heart J. 2017;38.
Henry TD, Bairey Merz CN, Wei J, et al. Autologous CD34+ stem cell therapy increases coronary flow reserve and reduces angina in patients with coronary microvascular dysfunction. Circ Cardiovasc Interv. 2022;15.
Magni G. The use of antidepressants in the treatment of chronic pain. Drugs. 1991;42:730–48.
pubmed: 1723371 doi: 10.2165/00003495-199142050-00002
Cox I, Hann CM, Kaski JC. Low dose imipramine improves chest pain but not quality of life in patients with angina and normal coronary angiograms. Eur Heart J. 1998;19:250–4.
pubmed: 9519318 doi: 10.1053/euhj.1997.0615

Auteurs

Federico Marchini (F)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Graziella Pompei (G)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Emanuele D'Aniello (E)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Andrea Marrone (A)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Serena Caglioni (S)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Simone Biscaglia (S)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Gianluca Campo (G)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.

Matteo Tebaldi (M)

Cardiology Unit, Azienda Ospedaliero Universitaria Di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy. tblmtt@unife.it.

Classifications MeSH