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Boudou N, Despas F, Rothem JV, et al. Direct evidence of sympathetic hyperactivity in patients with vasospastic angina. Am J Cardiovasc Dis. 2017;7(3):83-88
Boudou, N., Despas, F., Rothem, J. V., Lairez, O., Elbaz, M., Vaccaro, A., Lebrin, M., Pathak, A., & Carrié, D. (2017). Direct evidence of sympathetic hyperactivity in patients with vasospastic angina. American journal of cardiovascular disease, 7(3), 83-88.
Boudou, Nicolas, et al. "Direct evidence of sympathetic hyperactivity in patients with vasospastic angina." American journal of cardiovascular disease vol. 7,3 (2017): 83-88.
Boudou N, Despas F, Rothem JV, Lairez O, Elbaz M, Vaccaro A, Lebrin M, Pathak A, Carrié D. Direct evidence of sympathetic hyperactivity in patients with vasospastic angina. Am J Cardiovasc Dis. 2017 Jun 15;7(3):83-88. eCollection 2017. PMID: 28695054; PMCID: PMC5498819.
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Am J Cardiovasc Dis. 2017 Jun 15;7(3):83-88. eCollection 2017.

Direct evidence of sympathetic hyperactivity in patients with vasospastic angina.

American journal of cardiovascular disease

Nicolas Boudou, Fabien Despas, Jérôme Van Rothem, Olivier Lairez, Meyer Elbaz, Angelica Vaccaro, Marine Lebrin, Atul Pathak, Didier Carrié

Affiliations

  1. Department of Cardiology, University Hospital of RangueilToulouse, France.
  2. Inserm U1048, University Hospital of RangueilToulouse, France.
  3. Medical School of Rangueil, University Paul SabatierToulouse, France.
  4. Department of Nuclear Medicine, Toulouse University HospitalToulouse, France.
  5. Medical School of Purpan, University Paul SabatierToulouse, France.

PMID: 28695054 PMCID: PMC5498819

Abstract

BACKGROUND: The autonomic nervous system is reported to be involved in the pathogenesis of vasospastic angina (VSA). Studies based on heart rate variability analysis have shown conflicting results with both a reduction and an enhancement of sympathetic nervous system (SNS) activity in patients with Prinzmetal's variant angina, but direct assessment has never been performed. The aim of our study was to evaluate the SNS activity using microneurography in patients with VSA.

METHODS AND RESULTS: The SNS was evaluated by measuring the muscle sympathetic nerve activity (MSNA) with microneurography in 15 patients with VSA confirmed by positive ergonovine provocation test and 15 controls subjects negative for the provocation test. Over the baseline period, SNS activity was higher in patients with VSA compared with control patients (56.8 ± 5 vs. 49.3 ± 6.3 burst/min, p < 0.001, respectively). During mental stress, SNS activity increased significantly only in patients with VSA, which still presented a higher SNS activity than control patients (66.1 ± 7.2 vs. 53.6 ± 8.7 burst/min; p < 0.001, respectively). Furthermore only VSA patients showed significant hemodynamic modifications with an increase in mean arterial blood pressure (96.2 ± 13.4 vs. 86.6 ± 9.6 mmHg in VSA patients and control subjects, respectively; p < 0.05).

CONCLUSION: Our results provide the first direct evidence of lasting increased sympathetic activity that is worsened by mental stress in patients with VSA. These results suggest that SNS participate to the pathogenesis of VSA by enhancing coronary vascular tone.

Keywords: Coronary artery spasm; heart rate variability; muscle sympathetic nerve activity; sympathetic nervous system; vasospastic angina

Conflict of interest statement

None.

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