de Haro Miralles Joaquín, Gónzalez Aurora Flórez, Varela Casariego César, García Francisco Acín
Vascular Surgery Service, Hospital Universitario de Getafe, Madrid, Spain.
Interact Cardiovasc Thorac Surg. 2010 May;10(5):760-5. doi: 10.1510/icvts.2009.227967. Epub 2010 Feb 13.
Endothelial dysfunction and inflammation are understood to contribute to the onset of peripheral arterial disease (PAD), and endothelin (ET) may play an important role in this process. This study investigated the role of ET in PAD, and its relationships with symptoms, endothelial dysfunction and inflammation.
This cross-sectional study enrolled 141 participants: 66 patients with PAD and intermittent claudication, 37 patients with PAD and critical ischemia, and 38 healthy controls aged under 35 years. There were no gender distribution differences between control and diseased groups. Moreover, no differences were observed in age or cardiovascular risk factors distribution between patients with critical ischemia and patients with claudication. Plasma ET concentrations were significantly higher in patients vs. controls (8.76+/-77.1 vs. 6.45+/-0.89 pmol/l, respectively; P=0.002). Nevertheless, patients with claudication exhibited significantly higher plasma ET concentrations vs. patients with critical ischemia (10.97+/-7.9 vs. 4.82+/-2.57 pmol/l, respectively; P<0.001). Otherwise, significantly greater serum concentrations of C-reactive protein (CRP) were observed in patients with critical ischemia vs. patients with claudication (16.94 vs. 4.73 mg/l, respectively; P=0.001) and controls (0.96 mg/l; P=0.001). Plasma concentrations of ET had a modest negative correlation with serum concentrations of CRP (-0.165; P=0.095).
Plasma concentrations of ET in patients with PAD are greatest in early disease; ET concentrations decrease substantially and inflammation arises as disease advances. Serum CRP concentrations exhibit a modest negative correlation with those of ET.
内皮功能障碍和炎症被认为与外周动脉疾病（PAD）的发病有关，内皮素（ET）可能在此过程中起重要作用。本研究调查了ET在PAD中的作用及其与症状、内皮功能障碍和炎症的关系。
这项横断面研究纳入了141名参与者：66例患有PAD并伴有间歇性跛行的患者、37例患有PAD并伴有严重缺血的患者以及38名年龄在35岁以下的健康对照者。对照组和患病组之间在性别分布上没有差异。此外，严重缺血患者和间歇性跛行患者在年龄或心血管危险因素分布方面也未观察到差异。患者的血浆ET浓度显著高于对照组（分别为8.76±77.1与6.45±0.89 pmol/L；P = 0.002）。然而，与严重缺血患者相比，间歇性跛行患者的血浆ET浓度显著更高（分别为10.97±7.9与4.82±2.57 pmol/L；P < 0.001）。此外，与间歇性跛行患者相比，严重缺血患者的血清C反应蛋白（CRP）浓度显著更高（分别为16.94与4.73 mg/L；P = 0.001），且高于对照组（0.96 mg/L；P = 0.001）。血浆ET浓度与血清CRP浓度呈适度负相关（-0.165；P = 0.095）。
PAD患者血浆ET浓度在疾病早期最高；随着疾病进展，ET浓度大幅下降且炎症出现。血清CRP浓度与ET浓度呈适度负相关。
