title: Activation of polymorphonuclear leukocytes and increased plasma vasoconstrictors in vasospastic and nonvasospastic angina.
abstract: BACKGROUND
  The cause of coronary vasoconstriction in patients with angina at rest, nonsignificant coronary stenosis, and endothelial dysfunction remains unknown. Our objective was to investigate the association between enhanced coronary vasoconstriction and increased circulating levels of vasoconstrictor agents.
  
  
  METHODS
  Plasma levels of big endothelin-1, serotonin, and superoxide produced by polymorphonuclear leukocytes were measured in 38 patients with stable angina at rest without significant coronary artery stenosis-23 with nonvasospastic angina and 15 with vasospastic angina-and were compared with 10 patients with stable coronary disease and 20 age-matched controls.
  
  
  RESULTS
  Patients with angina at rest showed higher big endothelin-1 (1.28 vs 0.72 fmol/mL, P < 0.001), serotonin (18.0 vs 9.1 ng/mL, P = 0.002), and superoxide produced by polymorphonuclear leukocytes (177 vs 67 nmol/10 × E8 × minutes, P = 0.001) than did controls. Serotonin and superoxide produced by polymorphonuclear leukocytes were also higher than in coronary disease patients (5.4 ng/mL, P = 0.001, and 97 nmol/10 x E8 x minutes, P = 0.005), and big endothelin-1 levels tended to be higher (0.99 fmol/mL, P = 0.073). Moreover, there were no significant differences in these 3 parameters between patients with vasospastic and nonvasospastic angina, and among the latter, between patients with a positive and those with a negative exercise stress test.
  
  
  CONCLUSIONS
  Systemic plasma levels of agents with the potential to produce coronary vasoconstriction are increased in patients with stable vasospastic or nonvasospastic angina and, hence, may contribute to their angina, increased coronary tone, and impaired vasodilatory capacity. Furthermore, they may establish a mechanistic link between the 2 conditions.
authors.affiliation: Unitat Coronària and Laboratorio de Cardiología Experimental, Servei de Cardiologia, Barcelona, Spain. 5751jfb@comb.es
authors.forename: Jaume
authors.initials: J
authors.lastname: Figueras
authors.forename: David
authors.initials: D
authors.lastname: Garcia-Dorado
authors.forename: Luis
authors.initials: L
authors.lastname: Agulló
authors.forename: Josefa
authors.initials: J
authors.lastname: Cortadellas
authors.forename: Ferran
authors.initials: F
authors.lastname: Padilla
authors.forename: Enric
authors.initials: E
authors.lastname: Domingo
authors.forename: Rosa
authors.initials: R
authors.lastname: Galard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060050:Angina, Stable / Q000097:blood* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology*; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D012701:Serotonin / Q000097:blood; D013481:Superoxides / Q000097:blood; D014661:Vasoconstriction
chemical_list: D019332:Endothelin-1; D013481:Superoxides; D012701:Serotonin