The pathogenesis of vasospastic angina

Satoshi Yasuda, Hiroaki Shimokawa

Research output: Chapter in Book/Report/Conference proceedingChapter


Coronary artery spasm plays an important role in the pathogenesis of ischemic heart disease presentations, including sudden cardiac death, and thus could be one of the most important functional abnormalities of the coronary artery. Coronary spasm is caused primarily by smooth muscle hypercontraction whereas the contribution of endothelial dysfunction may be minimal. Rho-kinase is a downstream effector of the small GTP-binding protein Rho and consists of two isoforms, Rho-kinase α/ROCK2 and Rho-kinase β/ROCK1. Accumulative evidence have demonstrated that Rho-kinase plays a central role in the molecular mechanism of coronary spasm through vascular smooth muscle cell hyperconstriction. Furthermore, in the recent era of percutaneous coronary intervention with drug eluting stents (DES), Rho-kinase pathway also plays a crucial role in the pathogenesis of DES-induced coronary hyperconstricting responses. In this article, we will briefly review the current knowledge about the pathogenetic significance of the Rho-kinase pathway in coronary spasm and address the therapeutic potential of Rho-kinase inhibitors.

Original languageEnglish
Title of host publicationChest Pain with Normal Coronary Arteries
Subtitle of host publicationA Multidisciplinary Approach
PublisherSpringer-Verlag London Ltd
Number of pages9
ISBN (Electronic)9781447148388
ISBN (Print)1447148371, 9781447148371
Publication statusPublished - 2013 Sep 1


  • Myocardial ischemia
  • Rho-kinases
  • Vascular smooth muscle cell
  • Vasospasm

ASJC Scopus subject areas

  • Medicine(all)


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