title: Preserved endothelium-dependent vasodilation in coronary segments previously treated with balloon angioplasty and intracoronary irradiation.
abstract: BACKGROUND
  Abnormal endothelium-dependent coronary vasomotion has been reported after balloon angioplasty (BA), as well as after intracoronary radiation. However, the long-term effect on coronary vasomotion is not known. The aim of this study was to evaluate the long-term vasomotion of coronary segments treated with BA and brachytherapy.
  
  
  RESULTS
  Patients with single de novo lesions treated either with BA followed by intracoronary beta-irradiation (according to the Beta Energy Restenosis Trial-1.5) or with BA alone were eligible. Of these groups, those patients in stable condition who returned for 6-month angiographic follow-up formed the study population (n=19, irradiated group and n=11, control group). Endothelium-dependent coronary vasomotion was assessed by selective infusion of serial doses of acetylcholine (ACh) proximally to the treated area. Mean luminal diameter was calculated by quantitative coronary angiography both in the treated area and in distal segments. Endothelial dysfunction was defined as a vasoconstriction after the maximal dose of ACh (10(-6) mol/L). Seventeen irradiated segments (89.5%) demonstrated normal endothelial function. In contrast, 10 distal nonirradiated segments (53%) and 5 control segments (45%) demonstrated endothelium-dependent vasoconstriction (-19+/-17% and -9.0+/-5%, respectively). Mean percentage of change in mean luminal diameter after ACh was significantly higher in irradiated segments (P=0.01).
  
  
  CONCLUSIONS
  Endothelium-dependent vasomotion of coronary segments treated with BA followed by beta-radiation is restored in the majority of stable patients at 6-month follow-up. This functional response appeared to be better than those documented both in the distal segments and in segments treated with BA alone.
authors.affiliation: Thoraxcenter, Heartcenter, Rotterdam, Dijkzigt Academisch Ziekenhuis Rotterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Sabaté
authors.forename: I P
authors.initials: IP
authors.lastname: Kay
authors.forename: W J
authors.initials: WJ
authors.lastname: van Der Giessen
authors.forename: A
authors.initials: A
authors.lastname: Cequier
authors.forename: J M
authors.initials: JM
authors.lastname: Ligthart
authors.forename: J A
authors.initials: JA
authors.lastname: Gómez-Hospital
authors.forename: S G
authors.initials: SG
authors.lastname: Carlier
authors.forename: V L
authors.initials: VL
authors.lastname: Coen
authors.forename: J P
authors.initials: JP
authors.lastname: Marijnissen
authors.forename: A J
authors.initials: AJ
authors.lastname: Wardeh
authors.forename: P C
authors.initials: PC
authors.lastname: Levendag
authors.forename: P W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001610:Beta Particles; D001918:Brachytherapy / Q000295:instrumentation; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000628:therapy*; D003331:Coronary Vessels / Q000187:drug effects / Q000293:injuries / Q000503:physiopathology* / Q000528:radiation effects; D004730:Endothelium, Vascular / Q000293:injuries / Q000503:physiopathology* / Q000528:radiation effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000295:instrumentation; D014664:Vasodilation / Q000187:drug effects; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology
chemical_list: D009569:Nitric Oxide; D000109:Acetylcholine