Distension of urinary bladder induces exaggerated coronary constriction in smokers with early atherosclerosis

1 Cardiology Section, Department of Internal Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, 600 Taipei; 2 College of Medicine, National Cheng Kung University, Tainan; and 3 College of Public Health, National Taiwan University and 4 Department of Surgery, National Taiwan University Hospital, 600 Taipei, Taiwan Distension of the urinary bladder causes an increase in efferent sympathetic activity, which can precipitate myocardial ischemia. Smoking has been shown to modulate activities of afferent nerves from the distended urinary bladder and to impair endothelial function in response to sympathetic activation. To assess the effect of bladder distension on coronary dynamics in smokers, we measured epicardial and microvascular responses in 24 patients with early atherosclerosis (