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Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
08:42

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research

Published on: October 22, 2014

Inhomogeneous vasomotor effects of moderate selective and non-selective endothelin-receptor blockade in stable

P Wexberg1, W Sperker, N G Morgenthaler

  • 1Department of Cardiology, Division of Internal Medicine II, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. paul.wexberg@wienkav.at

Heart (British Cardiac Society)
|May 6, 2009
PubMed

Insights

Endothelin (ET)-receptor blockade showed varied individual hemodynamic responses in coronary artery disease (CAD) patients. A 30-minute infusion had a neutral effect, suggesting longer durations may be needed for distinct vasomotor responses.

Area of Science:

  • Cardiovascular Pharmacology
  • Endothelin Receptor Antagonism
  • Coronary Artery Disease Research

Background:

  • Endothelin (ET) system plays a role in cardiovascular regulation.
  • ET receptor blockade is a potential therapeutic strategy for cardiovascular diseases.
  • Understanding the effects of selective and non-selective ET receptor blockade is crucial for CAD management.

Purpose of the Study:

  • To investigate the morphological and functional impact of selective (ET-A) and non-selective (ET-A/ET-B) endothelin receptor blockade in patients with stable coronary artery disease (CAD).
  • To assess hemodynamic changes and their variability in response to ET receptor antagonists.

Main Methods:

  • A prospective, randomized controlled trial was conducted in a university hospital setting.
  • 26 patients with stable CAD received intracoronary infusions of ET-A blocker (BQ-123) alone or with an ET-B blocker (BQ-788).
  • Key outcome measures included fractional flow reserve (FFR), coronary flow reserve (CFR), intramyocardial resistance (IMR), and arterial blood concentrations of C-terminal pro-endothelin-1 (CT-proET1).

Main Results:

  • Intracoronary infusion of ET receptor antagonists did not significantly alter mean minimal lumen diameter (MLD), mean lumen diameter (LD), FFR, CFR, IMR, or mean arterial blood pressure (MAP) in either group.
  • Concentrations of CT-proET-1 increased significantly in both the ET-A blocker group and the combined blocker group.
  • Individual hemodynamic responses to ET receptor blockade demonstrated considerable variability.

Conclusions:

  • Selective and non-selective ET receptor blockade resulted in an overall neutral hemodynamic effect within a 30-minute infusion period in stable CAD patients.
  • Despite effective receptor blockade, a broad range of individual responses was observed.
  • Prolonged infusion times might be necessary to elicit more pronounced vasomotor effects.
Abstract

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