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Nitrite reverses nitroglycerin tolerance via repletion of a nitrodilator-activated nitric oxide store in vascular smooth muscle cells.
Redox Biol
January 2025
Department of Pediatrics, Division of Neonatology, Loma Linda University School of Medicine, Loma Linda, CA, USA; Lawrence D. Longo, MD Center for Perinatal Biology, Loma Linda University School of Medicine, Loma Linda, CA, USA. Electronic address:
Repeated use of nitroglycerin results in a loss of its vasodilatory efficacy which limits its clinical use for the treatment of angina pectoris. This tolerance phenomenon is a defining characteristic of all compounds classified as nitrodilators, which includes NTG as well as S-nitrosothiols and dinitrosyl iron complexes. These compounds vasodilate via activation of soluble guanylate cyclase, although they do not release requisite amounts of free nitric oxide (NO) and some do not even cross the plasma membrane.
View Article and Find Full Text PDFAnalysis of Metabolic Risk Factors for Microcirculation Disorders Post-Percutaneous Coronary Intervention and Predictive Model Construction: A Study on Patients with Unstable Angina.
Rev Cardiovasc Med
January 2025
Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000 Xuzhou, Jiangsu, China.
Background: This study aimed to analyze the metabolic risk factors for microcirculation disorders in patients with unstable angina (UA) after percutaneous coronary intervention (PCI), evaluating their predictive value for developing microcirculation disorders.
Methods: A single-center retrospective study design was used, which included 553 patients with UA who underwent PCI. The angiographic microcirculatory resistance (AMR) index was calculated based on coronary angiography data.
Subendocardial ischemia: does CMD really exist?
Cardiovasc Revasc Med
January 2025
Weatherhead PET Imaging Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, Houston, TX, United States of America.
Patients with angina but without obstructive epicardial coronary disease still require a specific mechanistic diagnosis to enable targeted treatment. The overarching term "coronary microvascular dysfunction" (CMD) has been applied broadly - but is it correct? We present a series of case examples culminating a systematic exploration of our large clinical database to distinguish among four categories of coronary pathophysiology. First, by far the largest group of "no stenosis angina" patients exhibits subendocardial ischemia during intact flow through diffuse epicardial disease during dipyridamole vasodilator stress.
View Article and Find Full Text PDFFunctional coronary microvascular dysfunction among patients with chronic kidney disease.
Cardiovasc Revasc Med
December 2024
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America.
Prognostic role of con-/discordant coronary flow reserve and microvascular resistance in coronary microvascular disease: a systematic review and network meta-analysis.
Open Heart
January 2025
Department of Cardiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
Background: Coronary microvascular disease (CMD) is defined as impaired coronary flow reserve (CFR) and/or increased microvascular resistance (MR) without significant epicardial coronary stenosis. This definition allows for discordant CFR and MR values within patients with CMD. The aim of this meta-analysis is to characterise the prognostic value and pathophysiological backgrounds of CFR and MR con-/discordance.
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