[The significance and implications of coronary endothelial injury and dysfunction in patients with angina].

OBJECTIVE

To investigate the role of coronary endothelial injury and dysfunction in the development and progress of coronary heart disease.

METHODS

20 patients with unstable angina (UA), 17 patients with stable angina (SA) and 18 patients without coronary heart disease (control) were studied. Nitric oxide (NO), endothelin (ET) and circulating endothelial cells (CEC) were measured with both coronary sinus and peripheral blood during percutaneous coronary intervention (PCI).

RESULTS

The level of NO in either coronary sinus or peripheral blood in patients with UA was lower, while the level of ET and CEC was markedly higher than that in the SA and control group (P < 0.01, or P < 0.05); The level of NO in SA was lower, while the level of ET and CEC was higher than those in the control group (P < 0.01, or P < 0.05). In UA patients, the level of NO in coronary sinus blood was lower (P < 0.05), while the level of ET and CEC was higher (P < 0.01, or P < 0.05) than that in peripheral blood. Similar differences appeared in patients with SA, but no obvious difference between coronary sinus and peripheral blood was observed in the control group (P > 0.05).

CONCLUSIONS

It is suggested that coronary endothelial injury and dysfunction occur universally in angina patients, being consistent with the severity of coronary heart disease. Aggravation of coronary endothelial injury and dysfunction may contribute to the progress of the disease and may be the pathophysiological basis of acute coronary incidents.