Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris.
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 less than 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 less than 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).(ABSTRACT TRUNCATED AT 250 WORDS)
Toyo-oka
T
T
Second Department of Internal Medicine, University of Tokyo, Japan.
Aizawa
T
T
Suzuki
N
N
Hirata
Y
Y
Miyauchi
T
T
Shin
W S
WS
Yanagisawa
M
M
Masaki
T
T
Sugimoto
T
T
D000109:Acetylcholine; D000788:Angina Pectoris, Variant / Q000097:blood* / Q000503:physiopathology; D009320:Atrial Natriuretic Factor / Q000097:blood; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D003329:Coronary Vasospasm / Q000139:chemically induced*; D016232:Endothelins / Q000097:blood*; D004874:Ergonovine; D005260:Female; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged
D016232:Endothelins; D009320:Atrial Natriuretic Factor; D000109:Acetylcholine; D004874:Ergonovine