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Life
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Coronary Artery Spasm—Features, Diagnosis, Pathogenesis, and Treatment
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Coronary Artery Spasm—Features, Diagnosis, Pathogenesis, and Treatment

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 18 December 2024 | Viewed by 8812

Special Issue Editors

Prof. Dr. Ming-Yow Hung

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Guest Editor
Department of Internal Medicine, Division of Cardiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
Interests: coronary artery disease; coronary artery spasm; myocardial ischemia; heart failure; electrocardiography
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Nicholas G Kounis

E-Mail Website
Guest Editor
Department of Cardiology, University of Patras Medical School, 26221 Patras, Greece
Interests: Kounis syndrome; coronary artery disease; coronary artery spasm; myocardial ischemia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Coronary artery spasm (CAS), an intense vasoconstriction of coronary arteries that causes total or subtotal vessel occlusion, plays an important role in myocardial ischemic syndromes including stable and unstable angina, acute myocardial infarction, and sudden cardiac death. Coronary angiography with provocative testing is currently the only method of diagnosing CAS. While CAS is often missed because of its infrequent incidence and the dilemma involved in its diagnosis, CAS occurs in about 13% of patients after stent implantation. As a result, CAS is not a standalone phenomenon, and is surely related to the procedures of percutaneous coronary intervention.

While the mechanisms underlying the development of CAS are still poorly understood, CAS appears to be a multifactorial disease but is not associated with the traditional risk factors for obstructive coronary artery disease. Given the substantial morbidity and mortality associated with CAS, there is a growing interest in invasive and non-invasive interventions that might improve the diagnosis and outcomes of CAS.

In this Special Issue, we aim to update the available and emerging strategies for the management of CAS. Specifically, we invite authors to submit manuscripts pertaining to the current and emerging mechanisms, and the potential related targets for future therapy. These issues welcome both original research papers and review articles.

Potential topics include but are not limited to the following:

  1. Pathophysiology of CAS, including but not limited to risk factors, precipitating factors, and potential mechanisms;
  2. Diagnosis of CAS by the present and future multimodality imaging;
  3. Epidemiology of CAS regarding geographic and racial heterogeneity;
  4. Medical treatment for CAS, including current medication treatment review and potential therapeutic targets;
  5. Invasive treatment for CAS, including percutaneous coronary intervention;
  6. Genetic predisposition to CAS, including results from genome-wide association studies.

Prof. Dr. Ming-Yow Hung
Prof. Dr. Nicholas G Kounis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronary artery spasm
  • inflammation
  • risk factors for coronary spasm
  • provocative tests for coronary spasm
  • managements for coronary spasm

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Published Papers (3 papers)

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Research

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13 pages, 1085 KiB  
Article
Cardio-Oncoimmunology: Cardiac Toxicity, Cardiovascular Hypersensitivity, and Kounis Syndrome
by Nicholas G. Kounis, Ming-Yow Hung, Cesare de Gregorio, Virginia Mplani, Christos Gogos, Stelios F. Assimakopoulos, Panagiotis Plotas, Periklis Dousdampanis, Sophia N. Kouni, Anastasopoulou Maria, Grigorios Tsigkas and Ioanna Koniari
Life 2024, 14(3), 400; https://doi.org/10.3390/life14030400 - 18 Mar 2024
Cited by 3 | Viewed by 2288
Abstract
Cancer therapy can result in acute cardiac events, such as coronary artery spasm, acute myocardial infarction, thromboembolism, myocarditis, bradycardia, tachyarrhythmias, atrio-ventricular blocks, QT prolongation, torsades de pointes, pericardial effusion, and hypotension, as well as chronic conditions, such as hypertension, and systolic and diastolic [...] Read more.
Cancer therapy can result in acute cardiac events, such as coronary artery spasm, acute myocardial infarction, thromboembolism, myocarditis, bradycardia, tachyarrhythmias, atrio-ventricular blocks, QT prolongation, torsades de pointes, pericardial effusion, and hypotension, as well as chronic conditions, such as hypertension, and systolic and diastolic left ventricular dysfunction presenting clinically as heart failure or cardiomyopathy. In cardio-oncology, when referring to cardiac toxicity and cardiovascular hypersensitivity, there is a great deal of misunderstanding. When a dose-related cardiovascular side effect continues even after the causative medication is stopped, it is referred to as a cardiotoxicity. A fibrotic response is the ultimate outcome of cardiac toxicity, which is defined as a dose-related cardiovascular adverse impact that lasts even after the causative treatment is stopped. Cardiotoxicity can occur after a single or brief exposure. On the other hand, the term cardiac or cardiovascular hypersensitivity describes an inflammatory reaction that is not dose-dependent, can occur at any point during therapy, even at very low medication dosages, and can present as Kounis syndrome. It may also be accompanied by anti-drug antibodies and tryptase levels. In this comprehensive review, we present the current views on cardiac toxicity and cardiovascular hypersensitivity, together with the reviewed cardiac literature on the chemotherapeutic agents inducing hypersensitivity reactions. Cardiac hypersensitivity seems to be the pathophysiologic basis of coronary artery spasm, acute coronary syndromes such as Kounis syndrome, and myocarditis caused by cancer therapy. Full article
(This article belongs to the Special Issue Coronary Artery Spasm—Features, Diagnosis, Pathogenesis, and Treatment)
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Review

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26 pages, 2089 KiB  
Review
Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders
by Filippo Luca Gurgoglione, Luigi Vignali, Rocco Antonio Montone, Riccardo Rinaldi, Giorgio Benatti, Emilia Solinas, Antonio Maria Leone, Domenico Galante, Gianluca Campo, Simone Biscaglia, Italo Porto, Stefano Benenati and Giampaolo Niccoli
Life 2024, 14(3), 292; https://doi.org/10.3390/life14030292 - 22 Feb 2024
Cited by 1 | Viewed by 3425
Abstract
Coronary vasomotor disorders (CVD) are characterized by transient hypercontraction of coronary vascular smooth muscle cells, leading to hypercontraction of epicardial and/or microvascular coronary circulation. CVDs play a relevant role in the pathogenesis of ischemia, angina and myocardial infarction with non-obstructive coronary arteries. Invasive [...] Read more.
Coronary vasomotor disorders (CVD) are characterized by transient hypercontraction of coronary vascular smooth muscle cells, leading to hypercontraction of epicardial and/or microvascular coronary circulation. CVDs play a relevant role in the pathogenesis of ischemia, angina and myocardial infarction with non-obstructive coronary arteries. Invasive provocative testing with intracoronary Acetylcholine (ACh) administration is the gold standard tool for addressing CVD, providing relevant therapeutic and prognostic implications. However, safety concerns preclude the widespread incorporation of the ACh test into clinical practice. The purpose of this review is to shed light on the pathophysiology underlying CVD and on the clinical role of the ACh test, focusing on safety profile and prognostic implications. We will also discuss contemporary evidence on the management of CVD and the role of the ACh test in driving a personalized approach of patients with CVD. Full article
(This article belongs to the Special Issue Coronary Artery Spasm—Features, Diagnosis, Pathogenesis, and Treatment)
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12 pages, 2355 KiB  
Review
An Insight into Kounis Syndrome: Bridging Clinical Knowledge with Forensic Perspectives
by Elena Forzese, Claudia Pitrone, Vincenzo Cianci, Daniela Sapienza, Antonio Ieni, Lorenzo Tornese, Alessio Cianci, Patrizia Gualniera, Alessio Asmundo and Cristina Mondello
Life 2024, 14(1), 91; https://doi.org/10.3390/life14010091 - 5 Jan 2024
Cited by 7 | Viewed by 2539
Abstract
Kounis syndrome (KS) is an acute coronary syndrome triggered by allergic or hypersensitivity reactions. Incidence rates vary, with studies reporting 19.4 per 100.000 among all admissions and 3.4% among allergy patients. This review explores the expanding understanding of KS, encompassing various manifestations, and [...] Read more.
Kounis syndrome (KS) is an acute coronary syndrome triggered by allergic or hypersensitivity reactions. Incidence rates vary, with studies reporting 19.4 per 100.000 among all admissions and 3.4% among allergy patients. This review explores the expanding understanding of KS, encompassing various manifestations, and focusing on both clinical data and forensic findings useful in performing a diagnosis. The pathophysiology of this syndrome involves a complex interplay between allergic reactions and the cardiovascular system. Mast cell activation, histamine release, leukotrienes, cytokines, and platelet activation can contribute to coronary events. Three types of classification systems (allergic angina, allergic myocardial infarction, allergic stent thrombosis) aid in categorizing presentations. The diagnosis of KS relies on clinical presentation, laboratory findings, and imaging. Postmortem assessment of KS is based on the integration of circumstantial data, autopsy, and histological findings. Biochemical and immunohistochemical analyses also contribute to postmortem diagnosis. In conclusion, a combined, multidisciplinary approach should be used to ease the diagnostic process, which is crucial for forensic practitioners in confirming KS occurrence. Full article
(This article belongs to the Special Issue Coronary Artery Spasm—Features, Diagnosis, Pathogenesis, and Treatment)
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