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S Kubik, S Thude, A Athanasiadis, U Sechtem, P E Ong, P768
Expansion of CD4+CD28null T-lymphocytes in patients with epicardial coronary spasm - A potential novel pathogenetic pathway, European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy564.P768, https://doi.org/10.1093/eurheartj/ehy564.P768Close - Share Icon Share
Extract
Background: Patients with angina despite angiographically unobstructed coronaries represent a diagnostic and therapeutic challenge. Epicardial coronary spasm is an important cause of angina in this setting. However, the underlying pathogenetic mechanisms are still incompletely understood. It has been shown that a special subset of T-lymphocytes (i.e. CD4+CD28null T-cells) expands in patients with acute coronary syndrome. However, data on circulating immune cells contributing to clinically relevant coronary spasm is scarce. Thus, the aim of this study was to assess whether expansion of CD4+CD28null T-cells is associated with epicardial spasm. Moreover, we sought to assess whether CD4+CD28null T-cells in patients with epicardial spasm express the KIR2DS2+/DAP12+ receptor profile as these T-cells exhibit cytotoxicity via expression of the activating killer cell-immunoglobulin-like receptor KIR2DS2.
Methods: We assessed 35 consecutive patients (22 men, age 57±14 years) with stable angina despite angiographically unobstructed coronary arteries (<50% stenosis) who underwent intracoronary acetylcholine (ACH) testing for the diagnosis of coronary spasm according to a standardized protocol. The ACH-test was considered to be “positive” in the presence of (a) angina, ischemic ECG shifts during the test and ≥90% focal or diffuse coronary diameter reduction (“epicardial spasm”) or (b) ischemic ST-shifts and angina in the absence of epicardial spasm (“microvascular spasm”). Expansion of CD4+CD28null T-cells as well as expression of the KIR2DS2+/DAP12+ receptor profile was assessed via flow cytometry. All measurements of the patient material were performed in the same manner, with the same staining, cytometer settings and gating.
