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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Transcardiac gradient of soluble adhesion molecules predicts progression of coronary artery disease
Hiromitsu Yamamoto1, Shiro Uemura, Yoshio Tomoda
1Department of Emergency and Critical Care Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara, Japan.
Insights
The transcardiac gradient of soluble vascular cell adhesion molecule-1 (sVCAM-1) is linked to endothelial dysfunction and predicts coronary atherosclerosis progression in patients with coronary artery disease (CAD). This finding highlights sVCAM-1
Area of Science:
- Cardiovascular Medicine
- Immunology
- Biochemistry
Background:
- Cellular adhesion molecules (CAMs) are upregulated on vascular endothelium during atherosclerosis.
- Soluble forms of CAMs (sCAMs) are proteolysed and detectable in circulation.
- Understanding sCAMs' role in coronary artery disease (CAD) is crucial.
Purpose of the Study:
- To investigate the relationship between the transcardiac gradient of soluble cellular adhesion molecules (sCAMs) and clinical characteristics of CAD.
- To assess sCAMs' correlation with angiographic severity, endothelial function, and atherosclerosis progression.
Main Methods:
- Studied 46 patients with stable CAD.
- Measured serum sCAM levels in the aortic and coronary sinuses using ELISA.
- Calculated transcardiac sCAM gradients and evaluated CAD severity, acetylcholine response, and 6-month atherosclerosis progression.
Main Results:
- Transcardiac sCAM gradient did not correlate with angiographic CAD severity.
- Elevated transcardiac sVCAM-1 gradient was associated with vasoconstrictive response to acetylcholine (Ach).
- Higher initial transcardiac sVCAM-1 gradient predicted coronary atherosclerosis progression over 6 months.
Conclusions:
- Elevated transcardiac sVCAM-1 gradient suggests persistent coronary artery activation and endothelial dysfunction.
- Transcardiac sVCAM-1 gradient may serve as a predictive index for atherosclerosis progression.
- Coronary circulating sVCAM-1 provides valuable functional and predictive insights into atherosclerosis.
Background:
During the development of atherosclerotic lesion, several types of cellular adhesion molecules (CAMs) are overexpressed on the surface of vascular endothelium. Some parts of these membrane proteins are proteolysed and are detected in blood as soluble forms.
Aims:
The purpose of this study is to investigate the relationship between the transcardiac gradient of soluble cellular adhesion molecules (sCAMs) and the clinical characteristics of coronary artery disease (CAD).
Methods:
We studied 46 patients with clinically stable CAD. Serum sCAM levels in both aortic sinus and coronary sinus were measured using enzyme-linked immunosorbent assay, and the transcardiac gradient of sCAMs was calculated. We also evaluated the angiographic severity of CAD, response of coronary artery to acetylcholine (Ach), as well as progression of coronary atherosclerosis over a 6-month period.
Results:
The transcardiac gradient of sCAMs did not correlate to the angiographic severity of coronary atherosclerosis. The transcardiac gradient of sVCAM-1 was significantly higher in patients with vasoconstrictive response to Ach than patients without vasoconstrictive response to Ach (191.5+/-98.2 vs. -9.2+/-14.1 ng/ml, P<0.05). Furthermore, patients who exhibited progression of coronary atherosclerosis had a higher transcardiac gradient of sVCAM-1 at the initial study than patients without progression (47.8+/-24.5 vs. -6.4+/-12.3 ng/ml, P<0.05).
Conclusions:
An elevated transcardiac gradient of sVCAM-1 may represent the persistent activation of coronary artery that is accompanied by endothelial dysfunction, and may be a predictive index of progression of coronary atherosclerosis. Measurement of coronary circulating sVCAM-1 could provide important functional and predictive information about atherosclerosis.
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