title: Time course of endothelium-dependent and -independent coronary vasomotor response to coronary balloons and stents. Comparison of plain and drug-eluting balloons and stents.
abstract: OBJECTIVE
  This study sought to determine the time dependency of the endothelium-dependent and -independent vascular responses after percutaneous coronary intervention (PCI) with drug-eluting (DEB) or plain balloons, bare-metal (BMS), and drug-eluting (DES) stents, or controls.
  
  
  BACKGROUND
  Long-term endothelial dysfunction after DES implantation is associated with delayed healing and late thrombosis.
  
  
  METHODS
  Domestic pigs underwent PCI using DEB or plain balloon, BMS, or DES. The dilated and stented segments, and the proximal reference segments of stents and control arteries were explanted at 5-h, 24-h, 1-week, and 1-month follow-up (FUP). Endothelin-induced vasoconstriction and endothelium-dependent and -independent vasodilation of the arterial segments were determined in vitro and were related to histological results.
  
  
  RESULTS
  DES- and BMS-treated arteries showed proneness to vasoconstriction 5 h post-PCI. The endothelium-dependent vasodilation was profoundly (p < 0.05) impaired early after PCI (9.8 ± 3.7%, 13.4 ± 9.2%, 5.7 ± 5.3%, and 7.6 ± 4.7% using plain balloon, DEB, BMS, and DES, respectively), as compared with controls (49.6 ± 9.5%), with slow recovery. In contrast to DES, the endothelium-related vasodilation of vessels treated with plain balloon, DEB, and BMS was increased at 1 month, suggesting enhanced endogenous nitric oxide production of the neointima. The endothelium-independent (vascular smooth muscle-related) vasodilation decreased significantly at 1 day, with slow normalization during FUP. All PCI-treated vessels exhibited imbalance between vasoconstriction-vasodilation, which was more pronounced in DES- and BMS-treated vessels. No correlation between histological parameters and vasomotor function was found, indicating complex interactions between the healing neoendothelium and smooth muscle post-PCI.
  
  
  CONCLUSIONS
  Coronary arteries treated with plain balloon, DEB, BMS, and DES showed time-dependent loss of endothelial-dependent and -independent vasomotor function, with imbalanced contraction/dilation capacity.
authors: Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, Austria.
authors: Christian A
authors: CA
authors: Plass
authors: Inna
authors: I
authors: Sabdyusheva-Litschauer
authors: Andreas
authors: A
authors: Bernhart
authors: Eslam
authors: E
authors: Samaha
authors: Ors
authors: O
authors: Petnehazy
authors: Eszter
authors: E
authors: Szentirmai
authors: Zsolt
authors: Z
authors: Petrási
authors: Victor
authors: V
authors: Lamin
authors: Noemi
authors: N
authors: Pavo
authors: Noemi
authors: N
authors: Nyolczas
authors: András
authors: A
authors: Jakab
authors: Zsolt
authors: Z
authors: Murlasits
authors: Jutta
authors: J
authors: Bergler-Klein
authors: Gerald
authors: G
authors: Maurer
authors: Mariann
authors: M
authors: Gyöngyösi
mesh_terms: D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000628:therapy*; D003329:Coronary Vasospasm / Q000473:pathology*; D004195:Disease Models, Animal; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000473:pathology*; D013552:Swine; D013997:Time Factors