Increased endogenous endothelin-1 in coronary circulation is associated with restenosis after coronary angioplasty.
BACKGROUND
The relationship between vasoactive substances, including endothelin-1, nitric oxide, serotonin, angiotensin II and noradrenaline, and coronary restenosis after percutaneous transluminal coronary angioplasty (PTCA) is not clear.


OBJECTIVE
To determine whether any vasoactive substance may be a marker of coronary restenosis after PTCA.


METHODS
Twenty-nine patients with angina pectoris underwent elective PTCA. Three months after PTCA, coronary angiography was performed again to study the patency of the lesions. Seven patients had coronary restenosis (greater than 50% stenosis) (restenosis group) and the rest of the patients were without restenosis (patency group). Their blood samples were obtained from the coronary sinus before, immediately after and three months after PTCA.


RESULTS
Endothelin-1 levels obtained immediately after PTCA (3.44+/-0.26 pg/mL) and three months after PTCA (3.57+/-0.29 pg/mL) were significantly higher than those obtained before PTCA (3.00+/-0.26 pg/mL) in the restenosis group, but not in the patency group (3.34+/-0.15 pg/mL, 3.02+/-0.17 pg/mL and 3.14+/-0.18 pg/mL, respectively). A transient decrease in nitrite/nitrate levels was observed immediately after PTCA in both groups. The serotonin levels three months after PTCA were significantly decreased in the patency group, but not in the restenosis group, and the levels of angiotensin II and noradrenaline did not change in either group throughout the study.


CONCLUSIONS
Among several vasoactive substances, endothelin-1 seems to be associated with the process of coronary restenosis after PTCA. Increased endothelin-1 levels in the coronary circulation after PTCA may indicate an increased risk of coronary restenosis.
Takase
Hiroyuki
H
Enshu General Hospital, Hamamatsu, Japan. h_takase@ken.ja-shizouka.or.jp
Sugiyama
Masaya
M
Nakazawa
Ai
A
Toriyama
Takayuki
T
Hayashi
Kunihiko
K
Goto
Takatoshi
T
Sato
Koichi
K
Ikeda
Koshiro
K
Ueda
Ryuzo
R
Dohi
Yasuaki
Y
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000804:Angiotensin II / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D019332:Endothelin-1 / Q000378:metabolism*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D009638:Norepinephrine / Q000378:metabolism; D012307:Risk Factors; D012701:Serotonin / Q000378:metabolism; D013223:Statistics as Topic; D014654:Vascular Patency / Q000502:physiology
D015415:Biomarkers; D019332:Endothelin-1; D000804:Angiotensin II; D009569:Nitric Oxide; D012701:Serotonin; D009638:Norepinephrine