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Plasma adrenomedullin levels in the coronary circulation in vasospastic angina pectoris

      Adrenomedullin is a potent vasodilator peptide that was originally isolated from human pheochromocytoma.
      • Kitamura K.
      • Kangawa K.
      • Kawamoto M.
      • Ichiki Y.
      • Nakamura S.
      • Matsuo H.
      • Eto T.
      Adrenomedullin a novel hypotensive peptide isolated from human pheochromocytoma.
      Recently, adrenomedullin production and secretion have been reported in both endothelial cells
      • Sugo S.
      • Minamino N.
      • Kangawa K.
      • Miyamoto K.
      • Kitamura K.
      • Sakata J.
      • Eto T.
      • Matsuo H.
      Endothelial cells actively synthesize and secrete adrenomedullin.
      and vascular smooth muscle cells.
      • Sugo S.
      • Minamino N.
      • Shoji H.
      • Kangawa K.
      • Kitamura K.
      • Eto T.
      • Matsuo H.
      Production and secretion of adrenomedullin from vascular smooth muscle cells augmented production by tumor necrosis factor-α.
      Sabates et al
      • Sabates B.L.
      • Pigott J.D.
      • Choe E.U.
      • Cruz M.P.
      • Lippton H.L.
      • Hyman A.L.
      • Flint L.M.
      • Ferrara J.J.
      Adrenomedullin mediates coronary vasodilation through adenosine receptors and KATP channels.
      demonstrated that the direct injection of adrenomedullin into the coronary artery produced an increase in coronary blood flow. These findings suggest that adrenomedullin may contribute to the control of coronary circulation. It has been suggested that vasospastic angina pectoris (VAP) is involved in endothelial injury or atherosclerosis, even though some of them appear to be normal angiographically. The precise mechanism of coronary artery spasm has not been revealed, but it has been suggested that vasoactive substances, including endothelin-1
      • Toyo-oka T.
      • Aizawa T.
      • Suzuki N.
      • Hirata Y.
      • Miyauchi T.
      • Shin W.S.
      • Yanagisawa M.
      • Masaki T.
      • Sugimoto T.
      Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris.
      and nitric oxide (NO)
      • Kugiyama K.
      • Yasue H.
      • Okumura K.
      • Ogawa H.
      • Fujimoto K.
      • Nakao K.
      • Yoshimura M.
      • Motoyama T.
      • Inoue Y.
      • Kawano H.
      Nitric oxide activity is deficient in spasm arteries of patients with coronary spastic angina.
      may be involved in the pathogenesis of VAP. This pilot study elucidates the role of adrenomedullin in VAP.
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