Circulation, Vol 74, 826-837, Copyright © 1986 by American Heart Association
K Egashira, H Tomoike, Y Yamamoto, A Yamada, Y Hayashi and M Nakamura
The pathogenesis of histamine-induced coronary spasm was examined
angiographically and morphometrically in Gottingen miniature pigs. In five
of 36 consecutive pigs that were 4 to 5 months of age, coronary spasm was
provoked by the intracoronary administration of histamine, and the left
coronary arteries were examined histologically without endothelial
denudation (group 1). Endothelial balloon denudation of the major branch of
the left coronary artery was performed in 31 of 36 pigs and five died
during the procedure. The remaining 26 pigs were randomly allotted to one
of two groups, one fed a cholesterol-supplemented (group 2, n = 13) and one
fed a regular low-cholesterol diet (group 3, n = 13). After 3 months, serum
cholesterol increased significantly from 57 +/- 6 to 222 +/- 27 mg/dl (p
less than .01) in group 2, but remained unchanged (48 +/- 5 to 55 +/- 6
mg/dl) in group 3. Percent narrowing of the coronary diameter induced by 10
micrograms/kg ic histamine after administration of the H2 blocker
cimetidine (60 mg/kg iv) was 39 +/- 3% and 24 +/- 2% (p less than .05
between groups 2 and 3) at the nondenuded site and 78 +/- 3% and 74 +/- 4%
at the denuded site in groups 2 and 3, respectively (p less than .01
between nondenuded and denuded sites). Histamine-induced percent narrowing
of the coronary diameter after cimetidine in group 1, 2, and 3 pigs
correlated well with the degree of intimal thickness on an exponential
curve (r = .92, p less than .001). Since percent narrowing at the intact
site was 27% (n = 19) in all three groups, predicted histamine-induced
percent narrowing at the spastic site, applying the geometric theory, was
33 +/- 3%. Accordingly, enhanced constriction of the coronary artery with
intimal thickening in response to histamine can largely be explained by the
acquired hyperresponsiveness of the vascular wall to autacoids. This
phenomena, not related to the level of serum cholesterol, may be uniquely
linked to the basic pathology of evolution of atherosclerosis.
ARTICLES
Histamine-induced coronary spasm in regions of intimal thickening in miniature pigs: roles of serum cholesterol and spontaneous or induced intimal thickening
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