Skip to main content

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 213))

  • 112 Accesses

Abstract

The term “syndrome X” was coined by Harvey Kemp in his 1973 editorial comment [1] on a puzzling report of electrocardiographic (ECG) signs of myocardial ischemia induced by pacing in the absence of detectable left ventricular dysfunction in a group of patients with angina and normal coronary angiograms [2]. This term proved to be well chosen as during the last quarter of the century this syndrome continued to be the object of conflicting reports and a variety of pathogenetic hypotheses.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kemp HG, Jr. Left ventricular function in patients with anginal syndrome and normal coronary arteriograms. Am J Cardiol 1973;32:375–376.

    Article  PubMed  Google Scholar 

  2. Arbogast R, Bourassa MG. Myocardial function during atrial pacing in patients with angina pectoris and normal coronary arteriograms. Comparison with patients having significant coronary artery disease. Am J Cardiol 1973;32:257–263.

    Article  PubMed  CAS  Google Scholar 

  3. Maseri A. Ischemic Heart Disease. A rational basis for clinical practice and clinical research. Churchill Livingstone Ed., 1995; pp. 507–532.

    Google Scholar 

  4. Cheng TO, Bashour T, Kelser G, et al:. Variant angina of Prinzmetal with normal coronary arteriograms. A variant of the variant. Circulation 1973;47:476–81.

    Article  PubMed  CAS  Google Scholar 

  5. Maseri A, Crea F, Kaski JC, Crake T. Mechanisms of angina pectoris in syndrome X. J Am Coll Cardiol 1991;17:499–506.

    Article  PubMed  CAS  Google Scholar 

  6. Buffon A, Santini S, Liuzzo G, et al. Increased lipoperoxidative stress may cause endothelial dysfunction in syndrome X. J Am Coll Cardiol 1996;29(Suppl. A):264A.

    Google Scholar 

  7. Buffon A, Santini SA, Rigattieri S, et al. Transient intracardiac lipid peroxidation induced by atrial pacing in syndrome X: a definitive demonstration of an ischemic mechanism? Circulation 1997;96:I-270.

    Google Scholar 

  8. Pasceri V, Lanza GA, Buffon A, Montenero AS, Crea F, Maseri A. Role of abnormal pain sensitivity and behavioral factors in determining chest pain in syndrome X. J Am Coll Cardiol 1998;31:62–66.

    Article  PubMed  CAS  Google Scholar 

  9. Poole-Wilson PA. Potassium and the heart. Clinics in endocrinology & metabolism 1984;13:249–268.

    Article  CAS  Google Scholar 

  10. Waldenström A, Ronquist G, Lagerqvist B. Angina pectoris patients with normal coronary angiograms but abnormal thallium perfusion scan exhibit low myocardial and skeletal muscle energy charge. J Intern Med 1992;231:327–31.

    Article  PubMed  Google Scholar 

  11. Clarke JG Davies GJ, Kerwin R, et al. Coronary artery infusion of neuropeptide Y in patients with angina pectoris. Lancet 1977;i:1057–59.

    Google Scholar 

  12. Larkin SW, Clarke JG, Keogh BE, et al. Intracoronary endothelin induces myocardial ischemia by small vessel constriction in the dog. Am J Cardiol 1989;64:956–58.

    Article  PubMed  CAS  Google Scholar 

  13. Koren W, Koldanov R, Peleg E, Rabinowitz B, Rosenthal T. Enhanced red cell sodium-hydrogen exchange in microvascular angina. Eur Heart J 1997;18:1296–1299.

    Article  PubMed  CAS  Google Scholar 

  14. Gaspardone A, Ferri C, Crea F, et al. Stimulated hyperinsulinemia in patients with microvascular angina is associated with enhanced red blood cell Na+-Li+ countertransport. Eur Heart J 1997;18(Abstr Suppl):157.

    Google Scholar 

  15. Motz W, Vogt M, Rabenau O, Scheler S, Lockhoff A, Strauer S. Evidence of endothelial dysfunction in coronary resistance vessels in patients with angina pectoris and normal coronary angiograms. Am J Cardiol 1991;68:996–1003.

    Article  PubMed  CAS  Google Scholar 

  16. Egashira K, Inou T, Hirooka Y, Yamada A, Urabe Y, Takeshita A. Evidence of impaired endothelium-dependent coronary vasodilation in patients with angina pectoris and normal coronary angiograms. N Engl J Med 1993;328:1659–64.

    Article  PubMed  CAS  Google Scholar 

  17. Lanza GA, Giordano AG, Pristipino C at al. Abnormal cardiac adrenergic nerve function in patients with syndrome X detected by [123I]metaiodobenzylguanidinw myocardial scintigraphy. Circulation 1997;96:821–6.

    Article  PubMed  CAS  Google Scholar 

  18. Lanza GA, Manzoli A, Pasceri V, et al. Ischemic-like ST-segment changes during Holter monitoring in patients with angina pectoris and normal coronary arteries but negative exercise testing. Am J Cardiol 1997;79:1–6.

    Article  PubMed  CAS  Google Scholar 

  19. Lanza GA, Manzoli A, Bia E, Crea F, Maseri A. Acute effects of nitrates on exercise testing in patients with syndrome X. Clinical and pathophysiological implications. Circulation 1994:90:2695–2700.

    Article  PubMed  CAS  Google Scholar 

  20. Camici PG, Gistri R, Lorenzoni R, et al. Coronary reserve and exercise ECG in patients with chest pain and normal coronary angiograms. Circulation 1992;86:179–186.

    Article  PubMed  CAS  Google Scholar 

  21. Rosen SD, Uren NG, Kaski JC, Tousoulis D, Davies GJ, Camici PG. Coronary vasodilator reserve, pain perception, and sex in patients with syndrome X. Circulation 1994;90:50–60.

    Article  PubMed  CAS  Google Scholar 

  22. Galassi AR, Crea F, Araujo LI, et al. Comparison of regional myocardial blood flow in syndrome X and one-vessel coronary artery disease. Am J Cardiol 1993;72:134–139.

    Article  PubMed  CAS  Google Scholar 

  23. Meeder JG, Blanksma PK, Crijns HGJM, et al. Mechanisms of angina pectoris in syndrome X assessed by myocardial perfusion dynamics and heart rate variability. Eur Heart J 1995;16:1571–7.

    PubMed  CAS  Google Scholar 

  24. Crake T, Canepa-Anson R, Shapiro L, Poole-Wilson PA. Continuous recording of coronary sinus oxygen saturation during atrial pacing in patients with coronary artery disease or with syndrome X. Br Heart J 1988;59:31–38.

    Article  PubMed  CAS  Google Scholar 

  25. Camici PG, Marraccini P, Lorenzoni R, Buzzigoli G, Pecori N, Perissinotto A, Ferrannini E, L’Abbate A, Marzilli M. Coronary hemodynamics and myocardial metabolism in patients with syndrome X: response to pacing stress. J Am Coll Cardiol 1991;17:1461–1470.

    Article  PubMed  CAS  Google Scholar 

  26. Tousoulis D, Crake T, Lefroy D, et al. Left ventricular hypercontractility and ST segment depression in patients with syndrome X. J Am Coll Cardiol 1993;22:1607.

    Article  PubMed  CAS  Google Scholar 

  27. Strauer BE. The significance of coronary reserve in clinical heart disease. J Am Coll Cardiol 1990;15:775.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Maseri, A., Lanza, G.A., Buffon, A. (1999). The Changing Concept of Syndrome X. In: Kaski, J.C. (eds) Chest Pain with Normal Coronary Angiograms: Pathogenesis, Diagnosis and Management. Developments in Cardiovascular Medicine, vol 213. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5181-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-5181-2_14

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7360-5

  • Online ISBN: 978-1-4615-5181-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics