Journal of Inflammation Research (Aug 2022)

Variant Angina is Associated with Myocarditis

  • Xu X,
  • Wang JJ,
  • Zhao H,
  • Miao K,
  • Cui G,
  • Zhang Y,
  • Yang X,
  • Wang L,
  • Wu J,
  • Wang DW

Journal volume & issue
Vol. Volume 15
pp. 4939 – 4949

Abstract

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Xin Xu,1,2,* James Jiqi Wang,1,2,* Hu Zhao,1,2 Kun Miao,1,2 Guanglin Cui,1,2 Yuxuan Zhang,1,2 Xiaoyun Yang,1,2 Luyun Wang,1,2 Junfang Wu,2 Dao Wen Wang1,2 1Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiological Disorders, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: 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 [email protected]; [email protected]: 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.Keywords: variant angina, myocarditis, cytokines, inflammation

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