2016


To access this material please log in or register

Register Authorize
2016/№2

Microvascular angina. Case report

Belenkov Yu. N., Privalova E. V., Yusupova A. O., Shchendrygina A. A.
State Budgetary Educational Institution of Higher Professional Education “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bldg. 2, Moscow 119991

Keywords: IHD, microcirculation, dysfunction of endothelium, trimetazidine

DOI: 10.18087/rhj.2016.2.2217

The article presents current aspects of etiology, pathogenesis, diagnostics and treatment of microvascular angina (MVA). A case report of a female patient with MVA is provided.
  1. Бокерия Л. А., Гудкова Р. Г. Сердечно-сосудистая хирургия – 2013. Болезни и врожденные аномалии системы кровообращения. – М.:Научный центр сердечно-сосудистой хирургии РАМН, 2014. – 220с [Bokeriya L. A., Gudkova R. G. Serdechno-sosudistaya xirurgiya – 2013. Bolezni i vrozhdenny`e anomalii sistemy` krovoobrashheniya. – M.:Nauchny`j czentr serdechno-sosudistoj xirurgii RAMN, 2014. – 220s].
  2. Montalescot G, Sechtem U, Achnbach S, Andreotti F, Arden C, Budaj A et al. ESC Guidelines on the management of stable coro­nary artery disease of the European Society of cardiology. Eur Heart J. 2013 Oct;34 (38):2949–3003.
  3. Davis KB, Chaitman B, Ryan T, Bittner V, Kennedy JW. Comparison of 15‑year survival for men and women after initial medical or surgical treatment for coronary artery disease: a CASS registry study. Coronary Artery Surgery Study. J Am Coll Cardiol. 1995 Apr;25 (5):1000–9.
  4. Pepine CJ, Anderson RD, Sharaf BL, Reis SE, Smith KM, Handberg EM et al. Coronary microvascular reactivity to adenosine predicts adverse outcome in women evaluated for suspected ischemia results from the National Heart, Lung and Blood Institute WISE (Women’s Ischemia Syndrome Evaluation) study. J Am Coll Cardiol. 2010 Jun 22;55 (25):2825–32.
  5. Von Arnim T. Prognostic significance of transient ischemic episodes: response to treatment shows improved prognosis. Results of the Total Ischemic Burden Bisoprolol Study (TIBBs) follow-up. J Am Coll Cardiol. 1996 Jul;28 (1):20–4.
  6. Larsen W, Mandleco B. Chest pain with angiographic clear coronary arteries: a provider’s approach to cardiac syndrome X. J Am Acad Nurse Pract. 2009 Jul;21 (7):371–6.
  7. Langille BL. Remodeling of developing and mature arteries: endothelium, smooth muscles, and matrix. J Cardiovasc Pharmacol.1993;21 (Suppl 1):S11–7.
  8. Kemp HG Jr, Vokonas PS, Cohn PF, Gorlin R. The anginal syndrome associated with normal coronary arteriograms. Report of a six year experience. Am J Med. 1973 Jun;54 (6):735–42.
  9. Wiedermann JG, Schwartz A, Apfelbaum M. Anatomic and physio­logic heterogeneity in patients with syndrome X: an intravascular ultrasound study. J Am Coll Cardiol. 1995 May;25 (6):1310–7.
  10. Camici PG, Crea F. Coronary microvascular dysfunction. N Engl J Med. 2007 Feb 22;356 (8):830–40.
  11. Halcox JP, Schenke WH, Zalos G, Mincemoyer R, Prasad A, Waclawiw MA et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation. 2002 Aug 6;106 (6):653–8.
  12. Sax FL, Cannon RO 3rd, Hanson C, Epstein SE. Impaired forearm vasodilator reserve in patients with microvascular angina. Evidence of a generalized disorder of vascular function? N Engl J Med. 1987 Nov 26;317 (22):1366–70.
  13. Johnson BD, Shaw LJ, Buchthal SD, Bairey Merz CN, Kim HW, Scott KN et al. Prognosis in women with myocardial ischemia in the absence of obstructive coronary disease: results from the National Institutes of Health-National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation (WISE). Circulation. 2004 Jun 22;109 (24):2993–9.
  14. Kuvin JT, Patel AR, Sliney KA, Pandian NG, Sheffy J, Schnall RP et al. Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J. 2003 Jul;146 (1):168–74.
  15. Bonetti PO, Pumper GM, Higano ST, Holmes DR Jr, Kuvin JT, Lerman A. Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol. 2004 Dec 7;44 (11):2137–41.
  16. Pizzi C, Manfrini O, Fontana F, Bugiardini R. Angiotensin-converting enzyme inhibitors and 3‑hydroxy-3‑methylglutaryl coenzyme A reductase in cardiac Syndrome X: role of superoxide dismutase activity. Circulation. 2004 Jan 6;109 (1):53–8.
  17. Bonetti PO, Lerman LO, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol. 2003 Feb 1;23 (2):168–75.
  18. Di Napoli P, Di Giovanni P, Gaeta MA, Taccardi AA, Barsotti A. Trimetazidine and reduction in mortality and hospitalization in patients with ischemic dilated cardiomyopathy: a post hoc analysis of the Villa Pini d'Abruzzo Trimetazidine Trial. J Cardiovasc Pharmacol. 2007 Nov;50 (5):585–9.
  19. Бубнова М. Г., Аронов Д. М., Оганов Р. Г., Рудоманов О. Г. Новые возможности триметазидина МВ в лечении ишемической болезни сердца в условиях реальной клинической практики. Результаты российского многоцентрового рандомизированного исследования «Перспектива» (часть II). Кардиоваскулярная терапия и профилактика. 2011;10 (6):70–80 [Bubnova M. G., Aronov D. M., Oganov R. G., Rudomanov O. G. Novy`e vozmozhnosti trimetazidina MV v lechenii ishemicheskoj bolezni serdcza v usloviyax real`noj klinicheskoj praktiki. Rezul`taty` rossijskogo mnogoczentrovogo randomizirovannogo issledovaniya “Perspektiva” (chast` II). Kardiovaskulyarnaya terapiya i profilaktika. 2011;10 (6):70–80].
  20. Danchin N, Marzilli M, Parkhomenko A, Ribeiro JP. Efficacy comparison of trimetazidine with therapeutic alternatives in stable angina pectoris: a network meta-analysis. Cardiology. 2011;120 (2):59–72.
  21. Belardinelli R, Solenghi M, Volpe L, Purcaro A. Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect. Eur Heart J. 2007 May;28 (9):1102–8.
  22. Yoon JW, Cho BJ, Park HS, Kang SM, Choi SH, Jang HC et al. Differential effects of trimetazidine on vascular smooth muscle cell and endothelial cell in response to carotid artery balloon injury in diabetic rats. Int J Cardiol. 2013 Jul 15;167 (1):126–33.
  23. Xu X, Zhang W, Zhou Y, Zhao Y, Liu Y, Shi D et al. Effect of trimetazidine on recurrent angina pectoris and left ventricular structure in elderly multivessel coronary heart disease patients with diabetes mellitus after drug-eluting stent implantation: a single-centre, prospective, randomized, double-blind study at 2‑year follow-up. Clin Drug Investig. 2014 Apr;34 (4):251–8.
  24. Rogacka D, Guzik P, Wykretowicz A, Rzezniczak J, Dziarmaga M, Wysocki H. Effects of trimetazidine on clinical symptoms and tole­rance of exercise of patients with syndrome X: a preliminary study. Coron Artery Dis. 2000 Mar;11 (2):171–7.
  25. Nalbantgil S, Altinti Gbreve A, Yilmaz H, Nalbantgil II, Onder R. The Effect of Trimetazidine in the Treatment of Microvascular Angina. Int J Angiol. 1999 Jan;8 (1):40–3.
Belenkov Yu. N., Privalova E. V., Yusupova A. O., Shchendrygina A. A. Microvascular angina. Case report. Russian Heart Journal. 2016;15 (2):75–81

To access this material please log in or register

Register Authorize
Ru En