Intracoronary endothelin receptor blockade improves endothelial function in patients with coronary artery disease

2008 ◽  
Vol 86 (11) ◽  
pp. 745-751 ◽  
Author(s):  
Felix Böhm ◽  
Jens Jensen ◽  
Bertil Svane ◽  
Magnus Settergren ◽  
John Pernow
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Substance P ◽  
Endothelial Function ◽  
Receptor Antagonist ◽  
Receptor Blockade ◽  
Flow Reserve ◽  
Artery Disease ◽  
Increased Blood Flow

Endothelin (ET)-1 receptor blockade improves endothelial function in the forearm of patients with atherosclerosis. The aim was to investigate whether intracoronary ET receptor blockade improves coronary endothelial function and increases blood flow in patients with coronary artery disease. Ten patients received a 60-minute infusion of either the selective ETA receptor antagonist BQ123 (40 nmol/min, n = 6) or BQ123 + the ETB receptor antagonist BQ788 (40 nmol/min, n = 4). In all patients, substance P, an endothelium-dependent vasodilator, did not increase baseline coronary flow reserve with thermodilution (CFRThermo) (0.71 ± 0.14 s during NaCl versus 0.59 ± 0.14 s during substance P) or baseline quantitative coronary angiography (QCA) (2.74 ± 0.16 mm versus 2.83 ± 0.20 mm). After ET receptor blockade, however, the response to substance P was significantly improved as determined both by CFRThermo (0.62 ± 0.14 s during NaCl versus 0.48 ± 0.10 s during substance P, p < 0.05) and by QCA (2.70 ± 0.18 mm versus 2.85 ± 0.19 mm, p < 0.05). In addition, ET blockade increased blood flow in all patients by 16% ± 10% (n = 10, p < 0.05) and in the BQ123 group by 22% ± 16% (n = 6, p < 0.05). Furthermore, ETA blockade increased blood flow significantly more than did dual ETA/ETB blockade (p < 0.05). These findings indicate that ET receptor blockade may be a new therapeutic strategy to improve coronary vascular function in patients with coronary artery disease.

Influence of phospholipase A2 and paraoxonase activity on endothelial function changes in various forms of coronary artery disease

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
VI Maslovskyi ◽  
IA Mezhiievska ◽  
YV Maslovskyi
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Phospholipase A2 ◽  
Brachial Artery ◽  
Vascular Disorders ◽  
Paraoxonase Activity ◽  
Artery Disease ◽  
Phospholipase A2 Activity

Abstract Funding Acknowledgements Type of funding sources: None. High phospholipase A2 activity is associated with atherosclerotic disorders of the arteries, while paraoxonase activity decreases with increasing atherogenic plasma activity. The purpose is to study the relationship between the combined effect of phospholipase A2 and paraoxonase activity on vascular endothelial dysfunction in various forms of coronary artery disease. We examined 152 men 52.5 ± 0.8 years, including 53 - STEMI, 32 - NSTEMI, 67 - chronic chronic coronary syndromes (CCS). Methods. All patients were examined for endothelial function of the brachial artery with a test for reactive hyperemia and vasodilation with exogenous NO, as well as determination of phospholipase A2 activity and plasma paraoxonase activity. All studiies conform to the principles of the Declaration of Helsinki of the World Medical Association. Results. Dynamics evaluation of endothelial function indicates a significant increase in blood flow in the brachial artery after compression in the NSTEMI group, but a decrease in the STEMI group after vasodilation of exogenous NO. Analysis of phospholipase A2 activity and paraoxonase showed an increasing the first in STEMI group compared to NSTEMI one and CCS while decreasing the second in the corresponding groups (Tab. 1). The results of the study confirm the association of increased activity of phospholipase A2 with vascular disorders severity, the correction of which should be considered a priority in prospective studies. The fact of reducing the activity of paraoxonase should be considered in the correction treatment of vascular disorders. Tab. 1 CCS NSTEMI STEMI LSD criteria D% 7,48 ± 0,39 6,65 ± 0,54 6,77 ± 0,62 {1-2} V% 54,71 ± 1,01 51,13 ± 1,92 42,16 ± 3,29 p1 &lt; 0,0001 p2 = 0,010 {3} / {1, 2} D% (NO) 10,35 ± 0,47 8,24 ± 0,96 10,28 ± 0,98 {1, 2} V% (NO) 55,60 ± 1,12 37,71 ± 3,72 p1 &lt; 0,0001 28,12 ± 3,94 p1 &lt; 0,0001 {1} / {2, 3} sPA2 1,12 ± 0,03 1,25 ± 0,04 p1 &lt; 0,0001 1,34 ± 0,04 p1 &lt; 0,0001 {1} / {2, 3} PAO 0,54 ± 0,01 0,50 ± 0,01 0,44 ± 0,01 p1 &lt; 0,0001 p2 &lt; 0,0001 {1} / {2,3} D% - diameter of brachial artery after compression. V% - blood flow velocity after compression. sPA2 -phospholipase A2. PAO - paraoxanase. p - reliability on Sheffe"s criteria.

13N-ammonia PET/CT stress myocardial blood flow compared to fractional flow reserve in coronary artery disease

2020 ◽  
Vol 41 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Jouke J. Boer ◽  
Johan J.J.S. Kappelhof ◽  
Friso M. van der Zant ◽  
Maurits Wondergem ◽  
Hans(J) B.R.M. de Swart ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stress Myocardial Blood Flow ◽  
Pet Ct ◽  
Artery Disease

Abstract 6094: Alterations in Blood Flow Reserve Secondary to Decompensated Diabetes Mellitus - Preliminary Results Obtained by Myocardial Contrast Echocardiography

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Natanael V Moraes ◽  
Carolina P Oliveira ◽  
Jeane Tsutsui ◽  
Antônio C Lerário ◽  
Wilson Mathias
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Blood Flow ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Contrast Echocardiography ◽  
Blood Glucose Control ◽  
Diabetic Patients ◽  
Flow Reserve ◽  
Artery Disease

Diabetes mellitus (DM) is one of the most important health problems in developed countries. Poor blood glucose control is known to be associated with clinical symptoms and increased risk for cardiovascular complications. Myocardial contrast echocardiography (MCE) has been demonstrated to be valuable for assessing myocardial blood flow reserve (MBFR) in patients with obstructive coronary artery disease and in those with microcirculatory alterations. We hypothesized that DM would result in impairment of MBFR, as measured by MCE, even in patients without obstructive coronary artery disease. Methods: We studied 30 patients with DM (mean age 55 years, 13 men) and 10 control subjects (mean age 53 years, 5 men) with normal global and regional systolic function. MBFR was determined by quantitative contrast echocardiography during dipyridamol (0.84 mg/Kg) stress using intravenous commercialy available microbubbles contrast (Definity, Bristol-Myers Squibb). Diabetic patients were studied in a decompensated state, with mean glycosylated hemoglobin of 9.0% (ranging from 8.5% to 13.0%). Quantification of peak myocardial intensity (A), microbubble velocity (Beta) and MBFR (peak dipyridamol/baseline AxBeta) were measured off line using Q-Lab software (Philips Medical Imaging). All patients underwent computed tomography coronary angiography (64 slices) which demonstrated no obstructive coronary artery disease. Results: Values of A (dB), Beta (1/s), and AxBeta (dB/s) both at baseline and during dipyridamol stress are described in Table . MBFR was significantly lower in patients with decompensated DM than in control subjects (1.58 versus 2.87; p<0.001). Conclusion: These preliminary results suggest that diabetic patients with poor blood glucose control and no obstructive coronary artery disease have impaired MBFR. MCE may be a useful noninvasive technique for evaluating changes in MBFR in this group of patients.

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