TY - JOUR
T1 - Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris
AU - Toyo-oka, Teruhiko
AU - Aizawa, Tadanori
AU - Suzuki, Nobuhiro
AU - Hirata, Yasunobu
AU - Miyauchi, Takashi
AU - Shin, Wee Soo
AU - Yanagisawa, Masashi
AU - Masaki, Tomoh
AU - Sugimoto, Tsuneaki
PY - 1991
Y1 - 1991
N2 - 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.
AB - 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.
KW - atrial natriuretic factor
KW - coronary circulation
KW - endothelin-1
KW - vasospastic angina
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U2 - 10.1161/01.CIR.83.2.476
DO - 10.1161/01.CIR.83.2.476
M3 - Article
C2 - 1825037
AN - SCOPUS:0025976655
SN - 0009-7322
VL - 83
SP - 476
EP - 483
JO - Circulation
JF - Circulation
IS - 2
ER -