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Endothelin-1 in patients with coronary heart disease undergoing cardiac catheterization
G Montalescot1, I Viossat, P E Chabrier
1Department of Cardiology, Centre Hospitalier Universitaire Pitié-Salpétrière, Paris, France.
Insights
Coronary atherosclerosis severity does not affect endothelin levels. Cardiac catheterization does not alter endothelin, but angioplasty increases urinary endothelin excretion for at least 24 hours.
Area of Science:
- Cardiovascular Research
- Endocrinology
- Vascular Biology
Background:
- Elevated circulating endothelin is observed in diffuse atherosclerosis and myocardial infarction.
- The specific relationship between coronary artery disease and endothelin release requires further clarification.
Purpose of the Study:
- To investigate the association between endothelin and coronary atherosclerosis.
- To assess endothelin synthesis and release during cardiac catheterization procedures.
Main Methods:
- Plasma and urinary endothelin immunoreactivity (ir-ET-1) were measured in 45 patients and 10 controls.
- Measurements were taken during and after cardiac catheterization, including coronary angioplasty and angiography.
Main Results:
- No immediate changes in plasma ir-ET-1 were observed during coronary angioplasty.
- Urinary ir-ET-1 levels significantly increased a few hours after coronary angioplasty, persisting for 24 hours.
- Neither plasma nor urinary ir-ET-1 levels changed during angiography or right heart catheterization alone.
Conclusions:
- Coronary atherosclerosis presence or severity is not linked to detectable endothelin release.
- Standard cardiac catheterization procedures do not alter plasma or urinary endothelin.
- Vascular events during coronary angioplasty elevate urinary endothelin excretion, detectable for up to 24 hours post-procedure.
Objectives:
This study examined the possible association between endothelin and coronary atherosclerosis and evaluated the synthesis and release of endothelin in the presence of various stimuli that occur during cardiac catheterization.
Background:
Circulating endothelin has been reported to be increased in diffuse atherosclerosis and acute myocardial infarction. However, the relation between coronary artery disease and endothelin release remains unclear.
Methods:
We measured the plasma and urinary concentrations of endothelin immunoreactivity in 45 patients and 10 healthy control subjects.
Results:
In group IA (n = 9), simultaneous blood sampling in the coronary sinus and femoral artery during coronary angioplasty of the left anterior descending coronary artery demonstrated no immediate changes in plasma immunoreactive endothelin-1 (ir-ET-1) levels. In 11 patients in group IB undergoing coronary angioplasty of a major artery, we did not detect changes in peripheral plasma concentrations of ir-ET-1 within 24 h, but urinary ir-ET-1 levels increased from 9.2 +/- 2.3 to 18.6 +/- 4.9 pg/mg of creatinine a few hours after coronary angioplasty (mean +/- SEM, p < 0.05). This increase in urinary endothelin excretion persisted 24 h later. Group II patients (n = 12) had coronary angiography without coronary angioplasty. Levels of both plasma and urinary ir-ET-1 did not change during the 24-h follow-up period. There was no relation between the severity of coronary atherosclerosis and the plasma or urinary concentrations of ir-ET-1. Systolic aortic pressure correlated with basal urinary excretion of endothelin (r = 0.54, p = 0.03, n = 15). In group III (n = 13), levels of ir-ET-1 in patients undergoing right heart catheterization without angiography did not differ from those in the control group.
Conclusions:
The presence or the severity, or both, of coronary atherosclerosis is not associated with a detectable increase in endothelin release. The diagnostic procedures of catheterization do not modify endothelin concentrations in plasma and urine. Vascular stretch or injury, or both, during coronary angioplasty increases urinary ir-ET-1 levels a few hours after the procedure. This increase persists for at least 24 h but is not detectable by brief sampling of peripheral or coronary sinus blood.