| Project/Area Number |
14570674
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | Kyushu University |
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Principal Investigator |
ITO Akira (2003) Kyushu University Hospital, Assist. Prof., 大学病院, 助手 (00360868)
毛利 正博 (2002) 九州大学, 医学部附属病院, 講師 (60264032)
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| Co-Investigator(Kenkyū-buntansha) |
SHIMOKAWA Hiroaki Kyushu University, Graduate School of Medical Sciences, Assoc. Prof., 大学院・医学研究院, 助教授 (00235681)
伊藤 昭 九州大学, 医学部附属病院, 医員
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| Project Period (FY) |
2002 – 2003
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| Project Status |
Completed (Fiscal Year 2003)
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| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2003: ¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 2002: ¥1,800,000 (Direct Cost: ¥1,800,000)
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| Keywords | angina pectoris / coronary microvessel / coronary vasospasm / Rho-kinase / myocardial ischemia / 冠循環 / 微小循環 / 微小血管狭心症 |
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| Research Abstract |
Effective treatment of patients with angina who have normal coronary arteriograms (microvascular angina) has not yet been established. Rho-kinase-mediated calcium sensitization of the myosin light chain in smooth muscle cells has been implicated as substantially contributing to vascular hyperconstriction. Accordingly, we sought to determine whether a potent Rho-kinase inhibitor fasudil prevents the occurrence of myocardial ischemia in patients with microvascular angina attributable to coronary microvascular spasm. We studied consecutive 18 patients with angina and normal epicardial coronaries in whom intracoronary acetylcholine (Ach) induced myocardial ischemia (ischemic electrocardiographic ahnges, myocardial lactate production, or both) without angiographically demonstrable epicardial coronary vasospasm. All patients underwent a second Ach challenge test after pretreatment with either saline (n=5) or fasudil (4.5mg intracoronarily, n=13). Myocardial ischemia was reproducibly induced by Ach in the saline group. In contrast, 11 of the 13 patients pretreated with fasudil had no evidence of myocardial ischemia during the second infusion of Ach (p<0.01). The lactate extraction ratio (median value [interquartile range]) during Ach infusion was improved by fasudil pretreatment, from -0.16 (-0.25 tp 0.04), to 0.09 (0.05 to 0.18) (p=0.0125). These results suggest that the inhibition of Rho-kinase may be a novel therapeutic strategy for this group of patients with microvascular angina.
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