title: Association between plasma lipoprotein(a) and endothelial dysfunction in normocholesterolemic and non-diabetic patients with angiographically normal coronary arteries.
abstract: The present study was designed to examine whether elevated levels of lipoprotein(a) (Lp(a)) are related to the impairment of the endothelium-dependent vasoresponse to acetylcholine (ACh) in normocholesterolemic and non-diabetic human normal coronary arteries. ACh (30 microg) was injected into the left main coronary artery of 31 patients (serum low-density cholesterol <160mg/dl and fasting plasma glucose <126mg/dl) with angiographically normal coronary arteries, and the relation between diameter change and lipid levels was analyzed. The mean diameter change of all coronary segments examined (segments 6, 8, 11 and 13) was reduced by 14.6+/-26.5% in response to ACh, but increased by 23.3+/-6.0% in response to nitroglycerin, suggesting endothelial dysfunction in those arteries. The mean diameter change of the left anterior descending artery or left circumflex artery in each patient was negatively correlated only with the level of Lp(a). Stepwise multiple regression analysis also revealed that only Lp(a) among the lipids showed significant correlation with impaired vasodilation (p=0.033). These findings suggest that elevated levels of plasma Lp(a) might be a strong predictor of endothelial dysfunction in normocholesterolemic and non-diabetic subjects.
authors.affiliation: Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ioka
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tasaki
authors.forename: Akira
authors.initials: A
authors.lastname: Yashiro
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ozumi
authors.forename: Masato
authors.initials: M
authors.lastname: Tsutsui
authors.forename: Ryouji
authors.initials: R
authors.lastname: Kouzuma
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okazaki
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Nakashima
mesh_terms: D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000792:Angiography; D002784:Cholesterol / Q000097:blood; D003331:Coronary Vessels / Q000187:drug effects / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D014661:Vasoconstriction / Q000187:drug effects; D014664:Vasodilation / Q000187:drug effects
chemical_list: D017270:Lipoprotein(a); D002784:Cholesterol; D005996:Nitroglycerin; D000109:Acetylcholine