Non-invasive and invasive detection of endothelial dysfunction and coronary vasospasm in patients with chest pain syndrome

Mortality from coronary artery disease is related to the severity of atherosclerotic changes on coronary arteries. However, patients with chest pain syndrome, but without significant changes on coronary arteries, exhibit the risk of disease progression and occurrence of severe adverse events, such as myocardial infarction, unstable angina, malignant rhythm disturbances and death. It is hypothesized that endothelial dysfunction and non specific vasoreactivity have important role in this group of patients. According to these assumptions the major areas of research and aims of the project have been defined: To create registry of the patients with chest pain syndrome and non-significant changes on coronary arteries Assessment of nonspecific vasoreactivity with intracoronary application of increasing doses of ergonovine Invasive and non-invasive assessment of endothelial dysfunction- intracoronary application of acetylcholine, ultrasonographic assessment of flow mediated vasodilatation of brachial artery, using EndoPAT device and blood concentrations of Von Willebrand’s factor (vWF) Assessment of arterial stiffness The aims of this research is to analyze pathophysiological mechanisms responsible for disease progression and the occurrence of adverse events in patients with chest pain syndrome and non significant changes on coronary arteries, in order to identify high risk patients.