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ABSTRACT: The aim of the study was to evaluate whether there was an imbalance between endothelin-1 (ET-1) and nitric oxide (NOx) release and diffuse atherosclerotic changes existed in patients with slow coronary flow (SCF). Baseline and post-atrial pacing coronary sinus ET-1 and NOx levels were measured in 19 patients with SCF (11 female, 56 +/- 9 years) and in 14 control subjects (nine female, 54 +/- 7 years). All patients underwent subsequent intravascular ultrasound (IVUS) investigation at the same setting with right atrial pacing. Baseline arterial (12.4 +/- 9.9 vs. 6.3 +/- 5.1 pg/ml, P<0.005) and coronary sinus (12.2 +/- 11.1 vs. 6.4 +/- 6.9 pg/ml, P<0.005) ET-1 plasma levels were higher in patients than in controls. After atrial pacing, concentration of ET-1 level from coronary sinus (24.7 +/- 14.6) significantly increased as compared to baseline (12.4 +/- 9.9, P<0.0001) and control levels (5.3 +/- 6.3, P<0.0001). Additionally, coronary sinus ET-1 level increased significantly with atrial pacing compared to femoral artery ET-1 level (16.3 +/- 8.5, P<0.005) in patients with SCF. After atrial pacing, the femoral artery ET-1 level also increased in patients compared to control level (P<0.0001). No significant differences in arterial and coronary sinus NOx plasma levels were found between the two groups, both at baseline and after pacing. Upon IVUS investigation, the common finding was longitudinally extended massive calcification throughout the epicardial arteries in patients with SCF. Mean intimal thickness was 0.59 +/- 0.18 mm. The data of this study suggest that increased ET-1 levels and insufficient NOx response, as well as the pathological data of IVUS may be associated with coronary microvascular dysfunction and may be the manifestation of early diffuse epicardial atherosclerosis in these patients with SCF.
International Journal of Cardiology 11/2004; 97(1):35-41. · 7.08 Impact Factor
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ABSTRACT: Background: Coronary slow flow (CSF) is characterized by delayed opacification of coronary arteries in the absence of epicardial occlusive disease. In this study, we aimed to determine endothelin-1 (ET-1), nitric oxide (NOx) levels and time domain heart rate variability (HRV) parameters in patients with CSF and relationship among these parameters.Methods: Thirty-three patients with CSF detected in the coronary angiography (17 females; mean age 55 ± 7) and 19 patients with normal coronary flow (10 females; mean age 54 ± 11) as a control group were enrolled in the study. Patients were divided into two groups according to exercise testing as if positive (group A, n = 8) or negative (group B, n = 25).Results: Plasma ET-1 levels were higher in the group A patients (28.7 ± 17.4 pg/ml) than that of group B (15.9 ± 10.6 pg/ml) and control group (6.0 ± 5.7 pg/ml); and higher in group B patients than that of control group (P < 0.05). Although groups A and B did not differ according to plasma NOx levels (23.4 ± 13.5 μmol/L vs. 32.8 ± 22.7 μmol/L, P > 0.05), NOx levels in group A were lower than the control group (23.4 ± 13.5 μmol/L versus 42.5 ± 15.9 μmol/L, P < 0.05). Time domain HRV parameters were decreased in all patient groups. This was more prominent in group A. Additionally, HRV parameters were negatively correlated with ET-1 and TIMI frame counts. TIMI frame count was also significantly correlated with ET-1 and NOx levels (r = 0.61, P < 0.0001, r =−0.30, P < 0.05). Upon intravascular ultrasonography investigation, the common finding was longitudinally extended massive calcification throughout the epicardial arteries. Mean intimal thickness was 0.50 ± 0.13 mm (group A; 0.58 ± 0.11 mm, group B 0.47 ± 0.12 mm, P = 0.029).Conclusions: The present study demonstrated that in patients with CSF, both increased plasma ET-1, decreased plasma NOx and diffuse atherosclerosis may cause the decrease in HRV by effecting myocardial blood flow.
Annals of Noninvasive Electrocardiology 01/2004; 9(1):24 - 33. · 1.10 Impact Factor
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ABSTRACT: Coronary slow flow (CSF) is characterized by delayed opacification of coronary arteries in the absence of epicardial occlusive disease. In this study, we aimed to determine endothelin-1 (ET-1), nitric oxide (NOx) levels and time domain heart rate variability (HRV) parameters in patients with CSF and relationship among these parameters.
Thirty-three patients with CSF detected in the coronary angiography (17 females; mean age 55 +/- 7) and 19 patients with normal coronary flow (10 females; mean age 54 +/- 11) as a control group were enrolled in the study. Patients were divided into two groups according to exercise testing as if positive (group A, n = 8) or negative (group B, n = 25).
Plasma ET-1 levels were higher in the group A patients (28.7 +/- 17.4 pg/ml) than that of group B (15.9 +/- 10.6 pg/ml) and control group (6.0 +/- 5.7 pg/ml); and higher in group B patients than that of control group (P < 0.05). Although groups A and B did not differ according to plasma NOx levels (23.4 +/- 13.5 micromol/L vs. 32.8 +/- 22.7 micromol/L, P > 0.05), NOx levels in group A were lower than the control group (23.4 +/- 13.5 micromol/L versus 42.5 +/- 15.9 micromol/L, P < 0.05). Time domain HRV parameters were decreased in all patient groups. This was more prominent in group A. Additionally, HRV parameters were negatively correlated with ET-1 and TIMI frame counts. TIMI frame count was also significantly correlated with ET-1 and NOx levels (r = 0.61, P < 0.0001, r =-0.30, P < 0.05). Upon intravascular ultrasonography investigation, the common finding was longitudinally extended massive calcification throughout the epicardial arteries. Mean intimal thickness was 0.50 +/- 0.13 mm (group A; 0.58 +/- 0.11 mm, group B 0.47 +/- 0.12 mm, P = 0.029).
The present study demonstrated that in patients with CSF, both increased plasma ET-1, decreased plasma NOx and diffuse atherosclerosis may cause the decrease in HRV by effecting myocardial blood flow.
Annals of Noninvasive Electrocardiology 01/2004; 9(1):24-33. · 1.10 Impact Factor
