United States: It is not easy to treat recurrent angina chest pain in patients with a specific form of heart disease, but researchers now report a potential breakthrough: a new hourglass-shaped stent.
Severe Limitations
Patients suffering from a condition that narrows the blood vessels of the heart, known as microvascular disease, saw a great improvement once they were given the new stent, researchers at Mayo Clinic, Rochester, Minnesota, found out, as reported by HealthDay.
That’s a big turnaround since “the patients with heart-related microvascular dysfunction in this study had little ability to control their chronic angina, which severely limited their day-to-day activities,” noted study senior author Dr. Amir Lerman, a Mayo cardiologist.
Understanding Angina
The American Heart Association states that angina cannot be regarded as a disease but as a sign of heart disease.
Angina is of two types and according to the AHA; it is defined as chest pain or discomfort that happens when the cardiac muscle is not supplied sufficient amount of oxygen-bearing blood. They may describe it as a pressure or like squeezing in the chest.” Sometimes, angina pain can also be mistaken for indigestion problems.”
Lerman’s team found that one important characteristic of this disease is recurrent chest pain. It is not the large vessels themselves that are occluded but much smaller ones, and as the ability of the heart to provide blood is decreased, the episodes of angina appear.
Microvascular disease was observed in up to two-thirds of the patients undergoing diagnostic coronary angiography for chest pain, according to the Mayo team.
Recurrent angina is also very disabling, and people are unable to perform normal activities of life. That is why there is not much that doctors can offer patients in this case, apart from enquiring whether they are on any specific medicines or recommending that they alter their diet.
Stents, of course, are used differently in other cases to open large arteries. The new stent with a more pinched-in-the-middle hourglass shape does indeed appear to re-establish blood flow to the capillaries Lerman and colleagues discovered.
The Hourglass Stent
The Mayo team reported that the stent produced worthwhile changes for patients with microvascular disease and angina in a clinical trial of 30 patients.
As they said, that might imply that a patient who was previously constrained to roaming around the block or climbing a flight of stairs without chest pain before the stent was able to do these basic tasks with relative ease and without any pain.
Quality-of-Life Benefits
“Beyond reductions in chest pain and being able to comfortably handle more physical activity, the majority of patients in the study also showed a connection between the changes in their coronary flow reserve, which is a measure of maximum blood flow, and changes in their quality-of-life responses on the survey,” Lerman said in a Mayo news release. “This points to the link between the physiological measurement and angina symptoms.”
And it is supposed that the special construction of the stent leads to the higher “back pressure” on the small vessels of the heart, thus improving the flow of blood circulation, as reported by HealthDay.
Remaining Challenges and Future Directions
However, the stent was not perfect, and the study also showed that 20% to 30% of people had no relief from the device. And why that is so is the focus of the discussion for the future research, according to Lerman.