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Endothelial dysfunction and inflammation in patients with non-obstructive coronary arteries
N N Pakhtusov1, A O Iusupova1, E V Privalova1
1I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Kardiologiia
|March 18, 2021
Summary
Patients with non-obstructive coronary artery disease show higher endothelin-1 levels and endothelial dysfunction, suggesting a role in ischemic heart disease (IHD) pathogenesis. Tumor necrosis factor-alpha was not a useful marker in this study.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Endothelial Function
Background:
- Ischemic heart disease (IHD) pathogenesis is complex and may involve factors beyond obstructive coronary artery disease (CAD).
- Endothelial dysfunction and inflammation are implicated in cardiovascular disease progression.
- Specific biomarkers like endothelin-1, E-selectin, and TNF-α are associated with endothelial dysfunction and inflammation.
Purpose of the Study:
- To investigate levels of endothelin-1, E-selectin, and TNF-α in patients with IHD.
- To compare these markers between patients with non-obstructive and obstructive coronary artery (CA) disease.
- To assess the association between endothelial dysfunction markers and IHD in the absence of significant CA stenosis.
Main Methods:
- Study included 32 patients with verified IHD, divided into non-obstructive (n=19) and obstructive (n=13) CA disease groups.
- Endothelial dysfunction assessed using photoplethysmography and videocapillaroscopy.
- Serum concentrations of endothelin-1, E-selectin, and TNF-α were measured.
Main Results:
- Patients with non-obstructive CA disease exhibited a trend towards more pronounced endothelial dysfunction compared to the obstructive group, though not statistically significant.
- Significantly higher concentrations of endothelin-1 were observed in the IHD group with non-obstructive CA disease (0.45 ng/ml) versus those with atherosclerotic stenosis (0.35 ng/ml, p=0.035).
- E-selectin concentrations did not differ significantly between groups. TNF-α levels were below the detection threshold in both groups.
Conclusions:
- Endothelial dysfunction and elevated endothelin-1 in non-obstructive CA disease may contribute to IHD pathogenesis.
- These findings suggest potential mechanisms for IHD development independent of hemodynamically significant CA stenoses.
- Low TNF-α levels precluded its use as a diagnostic marker; further research with larger cohorts and alternative markers is warranted.
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