Circulation, Vol 83, 476-483, Copyright © 1991 by American Heart Association
T Toyo-oka, T Aizawa, N Suzuki, Y Hirata, T Miyauchi, WS Shin, M Yanagisawa, T Masaki and T Sugimoto
To elucidate the pathogenic contribution of a potent vasoconstrictor,
endothelin-1, to coronary artery spasm, we provoked spasm with
intracoronary administration of acetylcholine or ergonovine and performed
sensitive immunoassays of plasma levels of endothelin-1 and atrial
natriuretic factor (ANF) in the peripheral vein and coronary sinus of
patients with a tentative diagnosis of vasospastic angina (VSA, n = 19).
The validity of coronary sinus blood sampling was verified by simultaneous
measurement of the ANF level. The plasma endothelin-1 levels in venous and
coronary sinus blood of the spasm- provoked patients (n = 12) were
1.71-fold and 2.16-fold higher, respectively, than those of nonprovoked
cases (n = 5, p less than 0.01). During left coronary spasm, the
endothelin-1 level in coronary sinus transiently decreased from 2.27 +/-
0.14 to 1.76 +/- 0.14 pg/ml (p less than 0.01) and returned to the control
level (1.98 +/- 0.20 pg/ml) after the spasm resolved, whereas the change
was equivocal during right coronary spasm. In contrast, the patients in
whom spasm was not provoked showed no changes and maintained low
endothelin-1 levels both before and after the maximal provocation (0.90 +/-
0.13 versus 0.90 +/- 0.13 pg/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Increased plasma level of endothelin-1 and coronary spasm induction in patients with vasospastic angina pectoris
Second Department of Internal Medicine, University of Tokyo, Japan.
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