Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris

Teruhiko Toyo-oka, Tadanori Aizawa, Nobuhiro Suzuki, Yasunobu Hirata, Takashi Miyauchi, Wee Soo Shin, Masashi Yanagisawa, Tomoh Masaki, Tsuneaki Sugimoto

Research output: Contribution to journalArticle

222 Citations (Scopus)

Abstract

To elucidate the pathogenic contribution of a potent vasoconstrictor, endothelin-1, to coronary artery spasm, we provoked spasm with intracoronary administration of acetylcholine or ergonovine and performed sensitive immunoassays of plasma levels of endothelin-1 and atrial natriuretic factor (ANF) in the peripheral vein and coronary sinus of patients with a tentative diagnosis of vasospastic angina (VSA, n=19). The validity of coronary sinus blood sampling was verified by simultaneous measurement of the ANF level. The plasma endothelin-1 levels in venous and coronary sinus blood of the spasm-provoked patients (n=12) were 1.71-fold and 2.16-fold higher, respectively, than those of nonprovoked cases (n=5, p<0.01). During left coronary spasm, the endothelin-1 level in coronary sinus transiently decreased from 2.27±0.14 to 1.76±0.14 pg/ml (p<0.01) and returned to the control level (1.98±0.20 pg/ml) after the spasm resolved, whereas the change was equivocal during right coronary spasm. In contrast, the patients in whom spasm was not provoked showed no changes and maintained low endothelin-1 levels both before and after the maximal provocation (0.90±0.13 versus 0.90±0.13 pg/ml). These findings imply that 1) low but significant concentrations of immunoreactive endothelin-1 circulate in the human systemic and coronary vascular beds, 2) an increased plasma endothelin-1 level may predispose but might not be sufficient per se to induction of the coronary spasm, 3) some inhibitory mechanism to endothelin-1 secretion may occur into the coronary circulation during the spasm, or 4) VSA might be classified to two subtypes or substages - a type (or stage) with a high endothelin-1 level responding to the drug provocation and another type (or stage) with a low endothelin-1 level that is nonresponsive to the provocation.

Original languageEnglish (US)
Pages (from-to)476-483
Number of pages8
JournalCirculation
Volume83
Issue number2
StatePublished - Feb 1991

Fingerprint

Spasm
Angina Pectoris
Endothelin-1
Coronary Sinus
Atrial Natriuretic Factor
Ergonovine
Coronary Circulation
Vasoconstrictor Agents
Immunoassay
Acetylcholine
Blood Vessels
Veins
Coronary Vessels

Keywords

  • Atrial natriuretic factor
  • Coronary circulation
  • Endothelin-1
  • Vasospastic angina

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Toyo-oka, T., Aizawa, T., Suzuki, N., Hirata, Y., Miyauchi, T., Shin, W. S., ... Sugimoto, T. (1991). Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris. Circulation, 83(2), 476-483.

Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris. / Toyo-oka, Teruhiko; Aizawa, Tadanori; Suzuki, Nobuhiro; Hirata, Yasunobu; Miyauchi, Takashi; Shin, Wee Soo; Yanagisawa, Masashi; Masaki, Tomoh; Sugimoto, Tsuneaki.

In: Circulation, Vol. 83, No. 2, 02.1991, p. 476-483.

Research output: Contribution to journalArticle

Toyo-oka, T, Aizawa, T, Suzuki, N, Hirata, Y, Miyauchi, T, Shin, WS, Yanagisawa, M, Masaki, T & Sugimoto, T 1991, 'Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris', Circulation, vol. 83, no. 2, pp. 476-483.
Toyo-oka T, Aizawa T, Suzuki N, Hirata Y, Miyauchi T, Shin WS et al. Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris. Circulation. 1991 Feb;83(2):476-483.
Toyo-oka, Teruhiko ; Aizawa, Tadanori ; Suzuki, Nobuhiro ; Hirata, Yasunobu ; Miyauchi, Takashi ; Shin, Wee Soo ; Yanagisawa, Masashi ; Masaki, Tomoh ; Sugimoto, Tsuneaki. / Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris. In: Circulation. 1991 ; Vol. 83, No. 2. pp. 476-483.
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AU - Miyauchi, Takashi

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