Published Online
on February 20, 2009

A more recent version of this article appeared on April 1, 2009

This Article Full Text (PDF) Data Supplement All Versions of this Article: 2/2/97    most recent CIRCINTERVENTIONS.108.803767v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nakagawa, H. Articles by Yasue, H. Search for Related Content PubMed Articles by Nakagawa, H. Articles by Yasue, H. Related Collections Acute coronary syndromes Endothelium/vascular type/nitric oxide Mechanism of atherosclerosis/growth factors Other Vascular biology Pathophysiology Other arteriosclerosis Smooth muscle proliferation and differentiation Related Article

Original Article

Coronary Spasm Preferentially Occurs at Branch Points: an angiographic comparison with atherosclerotic plaque

Hitoshi Nakagawa¹; Yoshinobu Morikawa¹; Yuji Mizuno¹; Eisaku Harada¹; Teruhiko Ito¹; Kunihiko Matsui²; Yoshihiko Saito³ and Hirofumi Yasue^1,4

¹ Kumamoto Aging Research Institute;
² Kumamoto University Hospital;
³ Nara Medical University

⁴ E-mail: yasue{at}juryo.or.jp

Background—Coronary spasm plays an important role in the pathogenesis of ischemic heart disease. However, similarities and differences between coronary spasm and atherosclerosis are not known. We examined the angiographic characteristics of coro-nary spasm in comparison with those of atherosclerosis.

Methods and Results—Thirty two left anterior descending (LAD), 11 left circumflex (LCx) and 23 right coronary arteries (RCA) with spasm and atherosclerotic plaque were analyzed for the localization of spasm in comparison with that of plaque in 47 patients (38 men and 9 women, mean age 66.8±10.3). Spasm predominantly occurred at the branch point as compared with plaque in each of the 3 arteries (76.7 vs. 23.3%, P<0.0001, 72.7 vs. 9.1%, P<0.039, and 60.0 vs. 10.0%, P= 0.002 %, in the LAD, LCx and RCA, respectively). Spasm involved the proximal segment less frequently as com-pared with plaque in each of the 3 arteries (56.7 vs. 93.3%, P<0.0001, 18.2. vs. 81.8%, P= 0.016, and 15.0 vs.75.0%, P<0.0001 in the LAD, LCx and RCA, respectively). The majority of spasm occurred at the non-plaque site in each of the 3 arteries (73.3 %, P=0.018, 100%, P<0.0001, and 75.0 %, P=0.041, in the LAD, LCx and RCA, respectively).

Conclusion—Coronary spasm preferentially occurred at branch points and non-plaque sites, whereas the atherosclerotic lesion was predominantly localized at the non-branch points of the curved proximal segments. Coronary spasm may thus be a manifestation of a distinct type of arteriosclerosis different from the lipid-laden coronary atherosclerosis.

Key Words: atherosclerosis • endothelium • nitric oxide • vasoconstriction • coronary spasm

Related Article

Coronary Spasm Preferentially Occurs at Branch Points: An Angiographic Comparison With Atherosclerotic Plaque

Hitoshi Nakagawa, Yoshinobu Morikawa, Yuji Mizuno, Eisaku Harada, Teruhiko Ito, Kunihiko Matsui, Yoshihiko Saito, and Hirofumi Yasue
Circ Cardiovasc Interv 2009 2: 97-104. [Abstract] [Full Text] [PDF]