Investigating problems in the small coronary arteries

Problems in the small blood vessels of the heart muscle is a common cause of angina, especially in women. So far, this cause of angina has been difficult to identify and we still lack a lot of knowledge in the field, not least about treatment. Henrik Engblom wants to change that with his research.

Portrait of professor Henrik Engblom at the hospital.
Photo: Stefan Zimmerman

What are you researching?

“My research focuses on diseases linked to the supply of blood to the heart muscle. Chest pain related to the heart, or angina pectoris, has traditionally been associated with problems in the large arteries of the heart, the coronary arteries. However, in recent years, we have seen that reduced function in the thousands of small vessels of the heart muscle can also be a common cause of disease.

My research nowadays is primarily about this type of angina pectoris. It is a field where there is a significant need for more knowledge – today we lack both a basic understanding of the disease’s mechanisms and effective treatments. In this research, we are primarily using a new method in magnetic resonance imaging. I have had the privilege of being in­volved with the first clinical validation study of this technique, measuring blood flow in the heart muscle in patients with angina pectoris.”

What have you found out so far? Is it a disease of its own?

“We see signs that it can appear both as a disease of its own and as part of more general atherosclerosis. In some patients it seems to be a precursor to a narrowing of the coronary arteries, while others only have problems in the small blood vessels of the heart alone. It is also clear that there is a significant difference between sexes – this affects women to a much grea­ter extent than it does men. Studies conducted in the US indicate that deterioration in the small vessels can be suspected in more than 50 percent of women who seek treatment for classic symptoms of angina pectoris. There is also a link to other diseases, such as diabetes, high blood pressure and inflammatory diseases such as systemic sclerosis.”

How will you proceed?

“We are presently making prepa­rations for both experimental and clinical studies to investigate whether anti-inflammatory treatment can have a positive effect. The patient study concerns the anti-inflammatory effect of exercise, while in the experimental study, the effect of anti-inflammatory drugs will be assessed. In parallel, we are continuing the research relating to the causes of the disease and how it affects the patient’s prognosis.”

Text: Anders Nilsson, first published in From Cell to Society 2020.

Henrik Engblom

Professor of Clinical Physiology at the Department of Molecular Medicine and Surgery

Henrik Engblom was born in Helsing­borg in 1978 and received his education and clinical training as a doctor at Lund University, receiving his degree in 2004. He earned a PhD at the same university in 2006 after defending his doctoral thesis, and became an associate pro-fessor in 2012.

Engblom received a doctor’s licence in 2008 and has been a specialist phy­sician in clinical physiology since 2015. Since 2009 he has held combination positions at Lund University and Skåne University Hospital with approximately equal parts of research and clinical activities. In connection with his move to KI, Engblom will also become a senior physician at Karolinska University Hospital.

Henrik Engblom was appointed Professor of Clinical Physiology at Karolinska Institutet on January 1, 2020.

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