Stewart J T, Nisbet J A, Davies M J
Department of Cardiological Sciences, St George's Hospital Medical School, London.
Br Heart J. 1991 Jul;66(1):7-9. doi: 10.1136/hrt.66.1.7.
To test the hypothesis that the active coronary endothelial lesions in unstable angina raise the endothelin concentration in coronary venous blood.
Systemic and coronary venous blood samples were obtained from unselected patients with the clinical syndromes of either stable or unstable angina at the time of cardiac catheterisation and coronary arteriography. Control venous blood samples were obtained from healthy laboratory workers and from patients with chronic renal failure treated by intermittent haemodialysis.
Twelve patients with angina: seven with stable symptoms and five with unstable angina.
The mean coronary venous endothelin concentration in unstable angina was 2.32 ng/l (range 1.7-3.2 ng/l). In stable angina it was 2.77 ng/l (range 2.1-4.4 ng/l). These values were not significantly different from one another nor from the values obtained in systemic venous blood from either group or from the healthy controls. Circulating endothelin concentrations were much higher in venous blood from the patients treated by haemodialysis.
These data do not support the hypothesis that raised endothelin concentrations in coronary blood in patients with unstable angina may modulate variations in coronary arterial tone thereby contributing to the clinical syndrome of chest pain and electrocardiographic changes at rest. The raised endothelin concentrations seen in systemic venous blood after myocardial infarction may be part of the systemic response to myocardial infarction.
验证不稳定型心绞痛患者冠状动脉内皮活性病变会升高冠状静脉血中内皮素浓度这一假说。
在进行心导管插入术和冠状动脉造影时，从患有稳定型或不稳定型心绞痛临床综合征的未经挑选的患者中采集全身和冠状静脉血样本。对照静脉血样本来自健康实验室工作人员以及接受间歇性血液透析治疗的慢性肾衰竭患者。
12例心绞痛患者，其中7例症状稳定，5例为不稳定型心绞痛。
不稳定型心绞痛患者冠状静脉内皮素平均浓度为2.32纳克/升（范围1.7 - 3.2纳克/升）。稳定型心绞痛患者为2.77纳克/升（范围2.1 - 4.4纳克/升）。这些数值彼此之间以及与两组全身静脉血或健康对照所获数值均无显著差异。接受血液透析治疗患者的静脉血中循环内皮素浓度要高得多。
这些数据不支持以下假说，即不稳定型心绞痛患者冠状血中内皮素浓度升高可能调节冠状动脉张力变化，从而导致胸痛临床综合征和静息心电图改变。心肌梗死后全身静脉血中内皮素浓度升高可能是对心肌梗死的全身反应的一部分。
