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Xu X, Wang JJ, Zhao H, Miao K, Cui G, Zhang Y, Yang X, Wang L, Wu J, Wang DW. Variant Angina is Associated with Myocarditis. J Inflamm Res 2022; 15:4939-4949. [PMID: 36060213 PMCID: PMC9439647 DOI: 10.2147/jir.s378152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background Vasospastic angina (VSA) is caused by severe diffuse or segmental coronary artery spasms. Patients with variant angina have poor clinical outcomes, although nitrates and calcium blockers help improve patient symptoms because there is no understanding of the etiology and causal treatment. The present study investigated whether VSA is associated with inflammation of the heart. Patients and Methods A total of 109 patients with VSA diagnosed by the presence of recurrent angina pectoris, typical electrocardiography, and coronary angiography were recruited, and 61 normal participants and 61 patients with acute myocardial infarction (AMI) and coronary artery stenosis were recruited as controls. The plasma levels of 24 cytokines were measured using a magnetic Luminex assay, and endothelin-1 and histamine levels tested using enzyme-linked immunosorbent assay and mass-spectrometry, respectively, for all participants. Furthermore, four patients with VSA underwent 18-fluorine fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). Results The plasma levels of interleukin (IL)-12p70, IL-13, PDL-1, IL-10, IL-6, IL-15, macrophage inflammatory protein (MIP)-1α, and MIP-1β in patients with VSA were significantly higher than those in both normal controls and patients with AMI (p<0.001) but did not differ between normal controls and patients with AMI. 18F-FDG PET/CT showed that the left ventricle, coronary perivascular tissue volume, and coronary perivascular FDG uptake were significantly increased in all four patients. Conclusion Our findings demonstrate that VSA patients have significantly elevated plasma cytokine levels and myocardial and pericoronary inflammation, suggesting that VSA is associated with myocarditis. This study provides novel insights into the etiology and treatment of VSA.
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Affiliation(s)
- Xin Xu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - James Jiqi Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Hu Zhao
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Kun Miao
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Guanglin Cui
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Yuxuan Zhang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Xiaoyun Yang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Luyun Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Junfang Wu
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China
- Correspondence: Dao Wen Wang; Junfang Wu, Division of Cardiology, Department of Internal Medicine Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave, Wuhan, 430030, People’s Republic of China, Tel/Fax +86-278366-3280, Email ;
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