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<PubmedArticle><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">37456775</PMID><DateRevised><Year>2023</Year><Month>07</Month><Day>18</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1758-3764</ISSN><JournalIssue CitedMedium="Internet"><Volume>18</Volume><PubDate><Year>2023</Year></PubDate></JournalIssue><Title>European cardiology</Title><ISOAbbreviation>Eur Cardiol</ISOAbbreviation></Journal><ArticleTitle>Mechanisms of Coronary Artery Spasm.</ArticleTitle><Pagination><StartPage>e39</StartPage><MedlinePgn>e39</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">e39</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.15420/ecr.2022.55</ELocationID><Abstract><AbstractText>Recent clinical trials have highlighted that percutaneous coronary intervention in patients with stable angina provides limited additional benefits on top of optimal medical therapy. This has led to much more attention being paid to coronary vasomotion abnormalities regardless of obstructive or non-obstructive arterial segments. Coronary vasomotion is regulated by multiple mechanisms that include the endothelium, vascular smooth muscle cells (VSMCs), myocardial metabolic demand, autonomic nervous system and inflammation. Over the years, several animal models have been developed to explore the central mechanism of coronary artery spasm. This review summarises the landmark studies on the mechanisms of coronary vasospasm demonstrating the central role of Rho-kinase as a molecular switch of VSMC hypercontraction and the important role of coronary adventitial inflammation for Rho-kinase upregulation in VSMCs.</AbstractText><CopyrightInformation>Copyright &#xa9; 2023, Radcliffe Cardiology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nishimiya</LastName><ForeName>Kensuke</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Takahashi</LastName><ForeName>Jun</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oyama</LastName><ForeName>Kazuma</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Matsumoto</LastName><ForeName>Yasuharu</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yasuda</LastName><ForeName>Satoshi</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shimokawa</LastName><ForeName>Hiroaki</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai, Japan.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2023</Year><Month>05</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur Cardiol</MedlineTA><NlmUniqueID>101574780</NlmUniqueID><ISSNLinking>1758-3756</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Coronary artery spasm</Keyword><Keyword MajorTopicYN="N">Rho-kinase</Keyword><Keyword MajorTopicYN="N">coronary adventitia</Keyword><Keyword MajorTopicYN="N">inflammation</Keyword><Keyword MajorTopicYN="N">perivascular adipose tissue</Keyword><Keyword MajorTopicYN="N">vascular smooth muscle cells</Keyword></KeywordList><CoiStatement>Disclosures: HS is on the European Cardiology Review editorial board; this did not influence peer review. 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