Key result
Variant angina is linked to ~61% lower coronary sinus 6-keto PGF1α versus controls.
Why the study?
The role of prostanoids in coronary artery spasm in variant angina patients was unclear and required investigation.
Are plasma levels of prostanoids (TX B2 and 6-keto PGF1α) altered in patients with variant angina compared to those with effort angina and healthy controls?
Observational (n=54)
Are plasma levels of prostanoids (TX B2 and 6-keto PGF1α) altered in patients with variant angina compared to those with effort angina and healthy controls?
Decreased PGI2 production, rather than elevated thromboxane A2, appears to be a primary factor in the pathogenesis of coronary artery spasm in variant angina.
May indicate prostacyclin deficiency promoting spasm in non-obstructive variant angina; leaves open whether prostanoid modulation alters clinical outcomes.
冠〓縮に果たすプロスタノイドの役割を研究するため, 21名の日本人異型狭心症患者および20名の労作性狭心症患者において冠静脈洞・上行大動脈で採血し血漿TX B2および6-keto PGF1αをradioimmumoassay法にて測定,対照群(冠動脈疾患を持たない群)13名の値と比較検討した.冠静脈洞血中TX B2値は対照群に比し労作性狭心症群で有意の高値(p<0.01)であつた.一方異型狭心症群のTX B2値は対照群に比し高値であつたが,有意の差を示すには至つていなかつた.しかし冠動脈造影上50%以上の狭窄病変を有する8例の異型狭心症群では, TX B2値は対照群より有意の高値(p<0.01)を示し,正常冠動脈もしくは50%未満の狭窄病変を有する異型狭心症群13例においてはTX B2値は対照群とほぼ同じ結果を示した.冠静脈洞および大動脈血中6-keto PGF1α値は異型狭心症群では対照群より低く,ことに正常冠動脈もしくは50%未満の器質的狭窄病変を有する異型狭心症群において,統計学的に有意(p<0.05)であつた.異型狭心症群では,エルゴノビン負荷により誘発された冠〓縮発作時および自然発作時のプロスタノイド値は特徴的変化を示さなかつた.以上の結果から,冠〓縮に際してみられるTX B2上昇は〓縮の結果によるものであり,むしろPGI2産生の低下が冠〓縮の原因としてより重要な要素であると考えられた.
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Shuzo Nomura (1985) conducted an observational in Variant angina (n=54). Variant angina without significant coronary stenosis vs. Controls without ischemic heart disease was evaluated on Coronary sinus plasma 6-keto PGF1α levels (pg/ml) (p=<0.05). Patients with variant angina without significant coronary stenosis had significantly lower coronary sinus levels of 6-keto PGF1α compared to controls (90 vs 232 pg/ml, p<0.05), suggesting decreased PGI2 production is a key factor in coronary spasm.
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