No change in endothelial-dependent vasomotion late after coronary irradiation.
OBJECTIVE
Mechanical injury from balloon angioplasty and stenting is known to cause prolonged endothelial dysfunction, even distal to the injured segment. Intravascular irradiation therapy is associated with delayed healing response and may therefore also impede endothelial functional recovery. This study was conducted to assess endothelial function late after the irradiation of atherosclerotic coronary arteries.


METHODS
In 15 patients (8 with additional radiation and 7 with stenting only), directly after the intervention and at 6-month follow-up, endothelial function of the distal segment was studied by assessment of coronary diameter after intracoronary acetylcholine (Ach). Coronary flow reserve (CFR) and intravascular ultrasound (IVUS) investigation were performed for unequivocal interpretation of angiographic data.


RESULTS
No significant different response to Ach could be detected at baseline nor at follow-up (-17 +/- 14% vs. -17 +/- 15% for radiation vs. nonradiation at baseline, P=1.0; -8 +/- 11% vs. -9 +/- 13% at follow-up, P=.8). IVUS data revealed more constrictive remodeling in the nonradiation patients, but a minimal increase in mean plaque area in the radiation patients compared with a significant decrease in nonradiation patients (+4% vs. -25%, P=.02).


CONCLUSIONS
Irradiation of atherosclerotic coronary arteries does not affect endothelium-dependent vasodilatation acutely or at 6 months. Irradiated segments demonstrated less negative remodeling but higher plaque burden than the controls did.
Hofma
Sjoerd H
SH
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
van Dalen
Bas M
BM
Lemos
Pedro A
PA
Ligthart
Jurgen M R
JM
Aoki
Jiro
J
McFadden
Eugene P
EP
Sianos
Georgios
G
van Essen
Dirk
D
de Feijter
Pim J
PJ
Serruys
Patrick W
PW
van der Giessen
Wim J
WJ
D000368:Aged; D000800:Angioplasty, Balloon; D001783:Blood Flow Velocity / Q000502:physiology; D001918:Brachytherapy / Q000009:adverse effects*; D006328:Cardiac Catheterization; D002302:Cardiac Output / Q000502:physiology; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*