Asma y enfermedad cardiovascular

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Resumen


Varios estudios epidemiológicos muestran que el asma, en especial la de inicio en la edad adulta, se asocia a enfermedad coronaria.
Los mecanismos que relacionan ambas enfermedades son desconocidos, aunque algunas observaciones clínicas, analíticas y anatomopatológicas
muestran que la enfermedad coronaria debida a una “isquemia miocárdica sin obstrucción coronaria” (IMSOC) muestra
unas características muy similares a las del asma. En concreto, la IMSOC se asocia con frecuencia a una inflamación eosinofílica mastocitaria
de los vasos coronarios y su gravedad se correlaciona con la intensidad de la eosinofilia en sangre y con los niveles de la inmunoglobulina
E en el suero. El vasoespasmo coronario ocasionado por estímulos como la acetilcolina es equiparable al broncoespasmo
ocasionado en el asma por estímulos similares. El tratamiento del asma mediante glucocorticoides inhalados reduce la eosinofilia en
las vías aéreas y en la sangre y previene el desarrollo de isquemia miocárdica en enfermos asmáticos. Todos estos datos dan soporte a
la hipótesis de que el asma y la enfermedad coronaria, en particular en su forma IMSOC, son dos procesos unidos por mecanismos
fisiopatológicos similares.


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