Vojácek J, Lisý O, Simek S, Kmonícek P, Rohác J, Jáchymová M, Jindra A
Department of Medicine II, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Cardiology. 1997 Jan-Feb;88(1):1-5. doi: 10.1159/000177288.
Endothelin plays an important role in cardiovascular pathology. As one of the most important endothelium-derived vasoconstrictor substances, endothelin together with endothelium-derived vasodilating factor control vascular tone and contribute to the vasoconstrictory response if the production of endothelium-derived vasodilating factor is impaired. The aim of the study was to assess the changes of the local endothelin level in coronary circulation immediately after percutaneous transluminal coronary angioplasty (PTCA). Plasma endothelin levels were measured in blood samples from the peripheral vein and ostium of the coronary artery before the angioplasty, and from the distal coronary artery just beyond the dilated segment and the peripheral vein immediately after the procedure. The plasma endothelin level was significantly higher in the ostium of the coronary artery already prior to PTCA as compared to the peripheral vein (10.9 +/- 3.4 vs. 7.2 +/- 2.1 pg/ml, p < 0.005). There was no change in the endothelin level in the coronary artery distal to the dilated segment immediately after the procedure as compared to the initial level, although this level was higher than the postangioplasty venous level (9.8 +/- 2.9 vs. 7.7 +/- 2.0 pg/ml, p < 0.005). Individual changes in coronary-artery plasma endothelin levels as a response to coronary angioplasty were disparate. An increase and a decrease in coronary artery plasma endothelin levels by more than 2 pg/ml after coronary angioplasty were observed in 3 and 6 subjects, respectively. In conclusion, increased plasma endothelin levels were found in blood samples drawn from the coronary artery as compared to the peripheral vein. There was no further change in the plasma endothelin level in the coronary artery distal to the dilated segment after angioplasty; however, the individual responses were disparate.
内皮素在心血管病理过程中发挥着重要作用。作为最重要的内皮源性血管收缩物质之一,内皮素与内皮源性血管舒张因子共同控制血管张力,并且如果内皮源性血管舒张因子的生成受损,内皮素会促使血管收缩反应。本研究的目的是评估经皮腔内冠状动脉成形术(PTCA)后即刻冠状动脉循环中局部内皮素水平的变化。在血管成形术前,从外周静脉和冠状动脉开口处采集血样测定血浆内皮素水平;在术后,从扩张段远端的冠状动脉及外周静脉即刻采集血样测定血浆内皮素水平。与外周静脉相比,PTCA术前冠状动脉开口处的血浆内皮素水平显著更高(10.9±3.4 vs. 7.2±2.1 pg/ml,p<0.005)。术后即刻,扩张段远端冠状动脉内的内皮素水平与初始水平相比无变化,尽管该水平高于血管成形术后的静脉水平(9.8±2.9 vs. 7.7±2.0 pg/ml,p<0.005)。冠状动脉血浆内皮素水平对冠状动脉成形术的个体变化各不相同。血管成形术后,分别在3例和6例受试者中观察到冠状动脉血浆内皮素水平升高和降低超过2 pg/ml。总之,与外周静脉相比,从冠状动脉采集的血样中血浆内皮素水平升高。血管成形术后,扩张段远端冠状动脉内的血浆内皮素水平无进一步变化;然而,个体反应各不相同。