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Effects of high-density lipoprotein on acetylcholine-induced coronary vasoreactivity
F E Kuhn1, E R Mohler, L F Satler
1Department of Medicine, Georgetown University Medical Center, Washington, D.C. 20007.
Insights
High-density lipoprotein (HDL) cholesterol positively correlates with healthy coronary artery function. Higher HDL cholesterol levels are linked to better acetylcholine-induced vasoreactivity in both smooth and diseased coronary segments, suggesting a protective role.
Area of Science:
- Cardiology
- Vascular Biology
- Biochemistry
Background:
- High-density lipoprotein (HDL) cholesterol is increasingly recognized for its vasoactive properties.
- Endothelial function, assessed via endothelium-dependent vasodilators like acetylcholine, is crucial in cardiovascular health.
- Atherosclerotic coronary artery disease is a major health concern linked to lipoprotein metabolism.
Purpose of the Study:
- To investigate the relationship between serum lipoproteins and acetylcholine-induced coronary vasoreactivity.
- To determine if HDL cholesterol levels correlate with endothelial function in coronary arteries.
- To assess vasoreactivity in both healthy and mildly diseased coronary artery segments.
Main Methods:
- Coronary arteriography was performed on 27 patients undergoing elective procedures.
- Acetylcholine was infused into the left main coronary artery to assess vasoreactivity.
- Coronary artery segments (smooth and diseased) were analyzed for changes in diameter post-infusion.
- Nitroglycerin was used to confirm intact vascular smooth muscle function.
Main Results:
- Acetylcholine induced significant vasoconstriction in both smooth and diseased coronary segments.
- A strong positive correlation was found between HDL cholesterol levels and normal acetylcholine-induced coronary vasoreactivity.
- This correlation was significant in both angiographically smooth (r = 0.59, p < 0.001) and diseased (r = 0.62, p < 0.02) segments.
- No significant correlation was observed between total cholesterol, LDL cholesterol, or total cholesterol to HDL ratio and vasoreactivity.
Conclusions:
- HDL cholesterol levels are positively associated with preserved endothelial function in coronary arteries.
- Higher HDL cholesterol may play a protective role in maintaining coronary vasoreactivity, even in the presence of mild atherosclerotic disease.
- These findings highlight the importance of HDL cholesterol in cardiovascular health beyond its role in lipid transport.
Abstract:
Recent evidence suggests that high-density lipoprotein (HDL) cholesterol has important vasoactive properties which may contribute to its beneficial effects on atherosclerotic coronary artery disease. The endothelium-dependent vasodilator acetylcholine has been used in a number of experimental studies to assess endothelial function. The relation between serum lipoproteins and acetylcholine-induced coronary vasoreactivity was investigated in patients (n = 27) undergoing elective coronary arteriography. Mean serum cholesterol, low-density lipoprotein cholesterol, HDL cholesterol and triglyceride levels were 189 +/- 7 (4.84 +/- 0.18 mmol/liter), 134 +/- 6 (3.47 +/- 0.15 mmol/liter), 41 +/- 3 (1.06 +/- 0.08 mmol/liter) and 106 +/- 30 mg/dl (1.20 +/- 0.03 mmol/liter), respectively. After a baseline arteriogram, acetylcholine was infused into the left main coronary artery and percent change from baseline dimension was determined in 27 angiographically smooth coronary artery segments and in 14 arterial segments with evidence of mild atherosclerotic disease. Intact vascular smooth muscle function was then confirmed in all segments by dilation to intracoronary nitroglycerin. Acetylcholine produced significant vasoconstriction of both angiographically smooth (13 +/- 4%, p less than 0.05 vs baseline) and diseased (19 +/- 4%, p less than 0.05 vs baseline) coronary segments. A positive correlation was observed between HDL cholesterol and normal acetylcholine-induced coronary vasoreactivity in both angiographically smooth (r = 0.59, p less than 0.001) and diseased (r = 0.62, p less than 0.02) coronary segments. No significant correlation was observed, however, between total and low-density lipoprotein cholesterol, or between total cholesterol to HDL ratio and the response of coronary artery diameter to acetylcholine infusion.(ABSTRACT TRUNCATED AT 250 WORDS)