Transcardiac gradient of soluble adhesion molecules predicts progression of coronary artery disease.
BACKGROUND
During the development of atherosclerotic lesion, several types of cellular adhesion molecules (CAMs) are overexpressed on the surface of vascular endothelium. Some parts of these membrane proteins are proteolysed and are detected in blood as soluble forms.


OBJECTIVE
The purpose of this study is to investigate the relationship between the transcardiac gradient of soluble cellular adhesion molecules (sCAMs) and the clinical characteristics of coronary artery disease (CAD).


METHODS
We studied 46 patients with clinically stable CAD. Serum sCAM levels in both aortic sinus and coronary sinus were measured using enzyme-linked immunosorbent assay, and the transcardiac gradient of sCAMs was calculated. We also evaluated the angiographic severity of CAD, response of coronary artery to acetylcholine (Ach), as well as progression of coronary atherosclerosis over a 6-month period.


RESULTS
The transcardiac gradient of sCAMs did not correlate to the angiographic severity of coronary atherosclerosis. The transcardiac gradient of sVCAM-1 was significantly higher in patients with vasoconstrictive response to Ach than patients without vasoconstrictive response to Ach (191.5+/-98.2 vs. -9.2+/-14.1 ng/ml, P<0.05). Furthermore, patients who exhibited progression of coronary atherosclerosis had a higher transcardiac gradient of sVCAM-1 at the initial study than patients without progression (47.8+/-24.5 vs. -6.4+/-12.3 ng/ml, P<0.05).


CONCLUSIONS
An elevated transcardiac gradient of sVCAM-1 may represent the persistent activation of coronary artery that is accompanied by endothelial dysfunction, and may be a predictive index of progression of coronary atherosclerosis. Measurement of coronary circulating sVCAM-1 could provide important functional and predictive information about atherosclerosis.
Department of Emergency and Critical Care Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara, Japan.
Hiromitsu
H
Yamamoto
Shiro
S
Uemura
Yoshio
Y
Tomoda
Shinichi
S
Fujimoto
Toshio
T
Hashimoto
Kazuo
K
Okuchi
D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D023921:Coronary Stenosis / Q000097:blood / Q000150:complications; D018450:Disease Progression; D019040:E-Selectin / Q000096:biosynthesis / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis / Q000097:blood*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D012995:Solubility; D013223:Statistics as Topic; D019010:Vascular Cell Adhesion Molecule-1 / Q000096:biosynthesis / Q000097:blood*
D015415:Biomarkers; D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1