Despite recent advances in the diagnosis and management of ischemic heart disease, it still remains a major cause of morbidity and mortality worldwide and thus warrants continuous challenges in therapeutics and research on its pathogenesis. It is widely accepted that ischemic heart disease is caused not only by plaque rupture and/or anatomical obstruction but also by epicardial and/or microvascular coronary spasm. Thus, further understanding on the pathogenesis of both atherosclerosis and vascular dysfunction and its translation into clinical practice are required for better management of ischemic heart disease. In particular, comprehensive understanding of vascular tone regulation, which plays an important role to develop vascular dysfunction, is necessary because new findings and insights have been accumulated in this field, including nitric oxide as an endothelium-derived relaxing factor (EDRF), H2O2 as an endothelium-derived hyperpolarizing factor (EDHF), and Rho-kinase pathway as a regulator of vascular smooth muscle contraction. In this chapter, we will briefly review the current concepts of cardiovascular events in ischemic heart diseases, particularly focusing on acute coronary events and vascular dysfunction, with a special reference to endothelial dysfunction, vascular tone, and microvascular angina.
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)