Brehm B R, Büttcher E, Beyer M E, Hoffmeister H M
Department of Cardiology, University of Tübingen, Germany.
J Cardiovasc Pharmacol. 1998;31 Suppl 1:S90-3. doi: 10.1097/00005344-199800001-00028.
The pathophysiologic meaning of elevated circulating endothelin-1 (ET-1) levels in various cardiovascular diseases is not understood. The aim of this study was to measure ET-1 and big ET-1 levels in patients with unstable angina pectoris (UAP) and within 5 days after stabilization. These values were compared to those of patients with stable angina pectoris (SAP) and to healthy controls (Co). In addition, a venous occlusion test was performed as an endothelial provocation test to characterize endothelial function. Big ET-1 levels were increased to 2.6 +/- 1.5 fmol/ml during unstable angina pectoris compared to normal values of 0.52 +/- 0.07 fmol/ml (p < 0.03; n = 14). After stabilization, big ET-1 decreased to 1.5 +/- 0.4 fmol/ml within 5 days (n.s.). ET-1 levels were not increased during UAP and after stabilization. ET-1 and big ET-1 levels from patients with SAP did not differ from those of healthy controls. The venous occlusion test resulted in an increase of ET-1 levels (0.3 +/- 0.02 to 0.46 +/- 0.02 fmol/mg, p = 0.008; SAP 0.3 +/- 0.04 to 0.39 +/- 0.05 fmol/ml, p = 0.009) in healthy controls and in patients with SAP. In contrast, patients with UAP showed no significant increase in ET-1 with this test. After stabilization for 5 days, the provocation test induced an increase in circulating ET-1 in patients with UAP comparable to that of controls (0.62 +/- 0.18 fmol/mg vs. 0.95 +/- 0.25 fmol/mg; p < 0.02). In summary, during UAP big ET-1 values are significantly increased and ET-1 values tend to be elevated. In an endothelial provocation test, ET-1 values did not increase. This might reflect a general activation of the endothelium in UAP during the acute stage, because the normal response is recovered 5 days later.
循环内皮素-1（ET-1）水平升高在各种心血管疾病中的病理生理意义尚不清楚。本研究的目的是测量不稳定型心绞痛（UAP）患者及其病情稳定后5天内的ET-1和大内皮素-1（big ET-1）水平。将这些值与稳定型心绞痛（SAP）患者及健康对照者（Co）的值进行比较。此外，进行静脉闭塞试验作为内皮激发试验以表征内皮功能。与正常水平0.52±0.07 fmol/ml相比，不稳定型心绞痛期间大内皮素-1水平升高至2.6±1.5 fmol/ml（p<0.03；n = 14）。病情稳定后，大内皮素-1在5天内降至1.5±0.4 fmol/ml（无统计学差异）。不稳定型心绞痛期间及病情稳定后ET-1水平未升高。SAP患者的ET-1和大内皮素-1水平与健康对照者无差异。静脉闭塞试验导致健康对照者和SAP患者的ET-1水平升高（分别从0.3±0.02升高至0.46±0.02 fmol/mg，p = 0.008；SAP患者从0.3±0.04升高至0.39±0.05 fmol/ml，p = 0.009）。相比之下，UAP患者在此试验中ET-1无显著升高。病情稳定5天后，激发试验使UAP患者循环ET-1升高，与对照者相当（0.62±0.18 fmol/mg对0.95±0.25 fmol/mg；p<0.02）。总之，在不稳定型心绞痛期间大内皮素-1值显著升高，ET-1值有升高趋势。在内皮激发试验中，ET-1值未升高。这可能反映了不稳定型心绞痛急性期内皮的普遍激活，因为正常反应在5天后恢复。
