Article

Soluble L-selectin and neutrophil derived oxidative stress after pacing induced myocardial ischemia in chronic stable coronary artery disease.

Medizinische Klinik II, Medizinischen Universität zu Lübeck, Germany.
Pacing and Clinical Electrophysiology (impact factor: 1.35). 04/2000; 23(3):309-14. pp.309-14
Source: PubMed

ABSTRACT We studied the effect of atrial pacing induced myocardial ischemia on levels of soluble L-selectin (sL-selectin) and generation of neutrophil derived reactive oxygen species (ROS) in 10 patients with coronary artery disease (CAD) and stable angina and in six individuals without CAD. Myocardial ischemia was measured metabolically by lactate sampling from the coronary sinus (CS) and arterial blood at each pacing step. Before each pacing step, at peak pacing and shortly after cessation, plasma concentrations of sL-selectin and generation of ROS using the chemiluminescence method were measured in CS and femoral artery blood. Baseline sL-selectin levels in CS samples were significantly lower in the CAD compared to the control group (547 +/- 80 vs 836 +/- 82 ng/mL, P = 0.03). At peak pacing, nine of ten patients with CAD developed myocardial ischemia (lactate extraction ratio at rest 28% +/- 7%, at peak pacing -16% +/- 6%). In these patients, luminol-enhanced chemiluminescence (CL, 0.88 +/- 0.45 vs 1.9 +/- 0.9 cpm x 10(5), P = 0.09) and levels of sL-selectin (547 +/- 80 vs 764 +/- 86 ng/mL, P = 0.03) from naive neutrophils increased significantly in CS blood suggesting a potent in vivo activation of neutrophils. In control patients, incremental pacing caused neither myocardial ischemia nor a significant change of chemiluminescence or of sL-selectin levels. In conclusion, myocardial ischemia induced by pacing tachycardia is able to activate neutrophils in patients with chronic stable coronary artery disease leading to increased generation of ROS and shedding of L-selectin into the coronary circulation.

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Keywords

activate neutrophils
 
arterial blood
 
atrial pacing induced myocardial ischemia
 
Baseline sL-selectin levels
 
chemiluminescence method
 
control group
 
coronary artery disease
 
coronary sinus
 
CS blood
 
femoral artery blood
 
incremental pacing
 
lactate extraction ratio
 
luminol-enhanced chemiluminescence
 
myocardial ischemia induced
 
naive neutrophils
 
pacing step
 
peak pacing
 
reactive oxygen species
 
sL-selectin levels
 
soluble L-selectin
 

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