Researchers Study Possible Genetic Link To Dysfunctional Coronary Arteries In Women.

2001 APR 19 - (NewsRx.com & NewsRx.net) -- Cardiologists have spent decades puzzling over what causes chest pain in many of their female patients. That's because the majority of women who complain of severe discomfort actually have coronary arteries that appear relatively normal in X-ray images of the heart.

Now University of Florida researchers report that many of these women have a genetic variation that could influence their blood vessels' ability to function properly - a theoretical cause of their distress. They released their findings at the American College of Cardiology's 50th Annual Scientific Session.

"One goal of our research is to try to determine whether there are factors in the lining of the coronary arteries that may be contributing to this chest pain syndrome," said Dr. Daniel Pauly, an assistant professor in the division of cardiovascular medicine at UF's College of Medicine. 'These women might not have any visible narrowing of the large coronary arteries by angiography, but we're trying to determine whether their vessels are functioning abnormally.

"This type of chest pain is a significant cause of women seeking medical attention," he added. "And because many seek medical attention or even seek emergency room attention, it is a significant cost burden for the health-care system."

Of those who visit a doctor for symptoms that suggest heart disease, women are much more likely than men to have coronary arteries free of obvious fatty obstructions that might account for their chest pain, Pauly said. In fact, only 30% or so of the women who undergo heart catheterization each year have atherosclerosis, compared with 85% of men who have the same procedure.

In the early 1970s, physicians labeled this condition "syndrome X." These women often are disabled by their recurrent symptoms. Today, doctors are still not sure how best to treat them, or even diagnose their condition. A further complication: some women who actually do have arterial blockages may never be referred for testing and treatment. That's because some physicians may be reluctant to give the referral, knowing that angiography doesn't always reveal any explanation for chest pain in women, said Dr. Carl Pepine, a professor and chief of cardiovascular medicine at UF.

Researchers studied 150 women whose symptoms were so frequent and severe they were referred for heart catheterization. This procedure involves placing a catheter into the heart's vessels to check for blockages or anatomic abnormalities that indicate heart disease. The women were participating in the $7 million, U.S. federally-funded Women's Ischemic Syndrome Evaluation study, known as WISE. The multicenter trial includes collaborators from the University of Pittsburgh, the University of Alabama, the Allegheny Health Science Center, and the U.S. National Institutes of Health.