This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (97)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Observations Linking the Clinical Spectrum of Ischemic Heart Disease to the Dynamic Pathology of Coronary Atherosclerosis

B. Greg Brown, MD, PhD

Arch Intern Med. 1981;141(6):716-722.

Abstract
• Patients with angina, myocardial infarction, and sudden death almost always have demonstrable coronary atherosclerosis. Furthermore, there is mounting evidence that coronary artery "spasm" is a contributing feature of these different coronary ischemic syndromes. Using quantitative angiography and two modes of -adrenergic stimulation in patients with spontaneous rest angina, vasomotor hyperreactivity was shown to be localized only to the region of a preexisting coronary atheroma. These observations support the hypothesis that a dynamic interaction between the histopathologic features of coronary atherosclerosis and "normal" amounts of coronary smooth-muscle shortening accounts for the clinical features in the great majority of cases in the spectrum of ischemic heart disease. There are various mechanisms of smooth-muscle shortening in an arterial stenosis, each with different therapeutic implications.

(Arch Intern Med 1981;141:716-722)

Author Affiliations
From the Department of Medicine, Cardiology Section, Wadsworth Veterans Administration Hospital, and UCLA School of Medicine, Los Angeles.

Footnotes
Accepted for publication May 12, 1980.

Reprint requests to Cardiology Section, 691/111E, Wadsworth Veterans Administration Hospital, Wilshire and Sawtelle Boulevards, Los Angeles, CA 90073 (Dr Brown).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Unstable Rest Angina with ST-Segment Depression: Pathophysiologic Considerations and Therapeutic Implications
OLIVA
ANN INTERN MED 1984;100:424-440.
ABSTRACT  

Unstable Angina: Guidelines for Therapy Based on the Last Decade of Clinical Observations
BROWN and DODGE
ANN INTERN MED 1982;97:921-923.
ABSTRACT