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Plasma endothelin-1 levels in patients with angina pectoris and normal coronary angiograms
E Hoffmann1, P Assennato, M Donatelli
1Cattedra di Cardiologia, Università degli Studi di Palermo, Italy.
Insights
Patients with microvascular angina, characterized by chest pain and normal coronary arteries, exhibit elevated levels of endothelin-1 (ET-1). This suggests ET-1 may contribute to the endothelial dysfunction observed in this condition.
Area of Science:
- Cardiology
- Vascular Biology
- Endocrinology
Background:
- Microvascular angina presents with typical angina symptoms and ischemia evidence despite normal coronary angiograms.
- This condition is linked to reduced coronary flow reserve and impaired endothelium-dependent vasodilation.
- Endothelin-1 (ET-1), a peptide derived from the endothelium, is a potent vasoconstrictor influencing microvascular function.
Purpose of the Study:
- To investigate the role of endothelin-1 (ET-1) in patients diagnosed with microvascular angina.
Main Methods:
- Plasma ET-1 concentrations were measured in 13 patients with typical angina, ischemia, and normal coronary arteriograms.
- Plasma ET-1 levels were also measured in 20 healthy control subjects for comparison.
Main Results:
- Patients with angina and normal angiograms showed significantly higher mean plasma ET-1 concentrations (2.89+/-1.24 pmol/L) compared to controls (1.99+/-0.81 pmol/L).
- Elevated ET-1 levels correlated with positive exercise test results for ischemia in patients with normal coronary arteriograms.
Conclusions:
- The findings support the hypothesis that endothelial dysfunction in microvascular angina involves impaired endothelin-1 (ET-1) activity.
- Endothelial dysfunction related to ET-1 may play a significant role in the pathophysiology of microvascular angina.
Background:
Some patients with typical angina and electrocardiographic evidence of ischemia have normal coronary angiograms. These patients have a reduced coronary flow reserve and abnormal endothelium-dependent vasodilator responses; this syndrome is known as microvascular angina. Among endothelium-derived peptides, endothelin-1 (ET-1) is a potent vasoconstrictor and an important modulator of microvascular function.
Methods:
Plasma ET-1 was measured in 13 patients with typical angina, instrumental evidence of ischemia, and normal arteriograms and in 20 normal control subjects.
Results:
Mean concentration of ET-1 was 2.89+/-1.24 pmol/L in patients with angina and normal angiograms and 1.99+/-0.81 pmol/L in normal control subjects (p < 0.02). Plasma levels of ET-1 values were significantly higher in patients with angina, positive exercise test results for ischemia, and normal coronary arteriograms compared with the group of patients with no clinical or instrumental evidence of ischemia.
Conclusions:
This is consistent with the hypothesis that in patients with microvascular angina, an endothelial dysfunction in the coronary vascular area caused by impaired endothelium-derived ET-1 could play an active role in the disease process.