Cardiovascular Sciences Department, Sapienza University, Rome, Italy.
Laboratory Medicine, S. Eugenio Hospital, Rome, Italy.
Intern Emerg Med. 2019 Oct;14(7):1119-1124. doi: 10.1007/s11739-019-02095-3. Epub 2019 May 8.
This study was aimed at evaluating whether transient dipyridamole-induced myocardial ischemia in hypertensive patients reflects on endothelin-1 plasma levels by comparing normotensives and hypertensives with or without stable angina. Endothelin-1 plasma levels were assessed in baseline conditions and after provocative stress test by dipyridamole. Four groups of ten age- and sex-matched subjects were retrospectively considered among patients referred for chest pain evaluation and submitted to high-dose Dipyridamole Echocardiographic-Scintigraphic combined test (DES). On the basis of DES results we considered: (1) control normotensives subjects; (2) essential hypertensives (for both groups negative result of DES); (3) essential hypertensives with stable angina; and (4) normotensives with stable angina (for both groups concordant DES detection of myocardial ischemia). Our data showed a marked post-DES increase of endothelin-1 plasma levels in hypertensives with stable angina (mean levels = 16.50 ± 4.19 pg/ml p < 0.001 vs. baseline = 9.05 ± 1.37 pg/ml) and a minor increase in stable angina pts (mean levels = 8.3 ± 1.75 pg/ml p < 0.01 vs. baseline = 6.74 ± 0.61 pg/ml) whereas non significant increase was observed both in control (mean levels = 5.09 ± 0.83 pg/ml p = n.s. vs. baseline = 4.91 ± 1.04 pg/ml) and hypertensives groups (mean levels = 6.34 ± 1.72 pg/ml p = n.s. vs. baseline = 5.95 ± 1.04 pg/ml). ET-1 involvement in hypertension-related ischemic heart disease patho-physiology appears to be considered.
这项研究旨在评估高血压患者短暂性双嘧达莫诱导的心肌缺血是否通过比较伴有或不伴有稳定型心绞痛的正常血压者和高血压患者的内皮素-1 血浆水平来反映。在基线条件下和双嘧达莫激发应激试验后评估内皮素-1 血浆水平。在因胸痛评估而转介并接受高剂量双嘧达莫超声心动图-闪烁照相联合试验（DES）的患者中，回顾性地考虑了四组年龄和性别匹配的受试者，每组 10 名。根据 DES 结果，我们考虑了：（1）对照正常血压者；（2）原发性高血压患者（两组的 DES 结果均为阴性）；（3）伴有稳定型心绞痛的原发性高血压患者；（4）伴有稳定型心绞痛的正常血压者（两组均一致检测到心肌缺血的 DES）。我们的数据显示，伴有稳定型心绞痛的高血压患者在双嘧达莫后内皮素-1 血浆水平显著升高（平均水平=16.50±4.19pg/ml，p<0.001 与基线值=9.05±1.37pg/ml），稳定型心绞痛患者的升高较小（平均水平=8.3±1.75pg/ml，p<0.01 与基线值=6.74±0.61pg/ml），而对照组（平均水平=5.09±0.83pg/ml，p=n.s. 与基线值=4.91±1.04pg/ml）和高血压组（平均水平=6.34±1.72pg/ml，p=n.s. 与基线值=5.95±1.04pg/ml）的升高均不显著。内皮素-1 可能参与了高血压相关缺血性心脏病的病理生理过程。
