From the Division of Cardiology, Kumamoto University School of Medicine
(K.K., H.D., T. Motoyama, H.S., K.M., H.K., O.N., M.Y., H.O., T. Matsumura,
S.S., H.Y.), Kumamoto, Japan; and Japan Immunoresearch Laboratories (T.N.,
K.N.), Takasaki, Japan.
Correspondence to Kiyotaka Kugiyama, MD, Division of Cardiology, Kumamoto University School of Medicine, Honjo 1–1-1, Kumamoto City, Japan 860-8556. E-mail kiyo{at}gpo.kumamoto-u.ac.jp
Background—It remains undetermined
whether triglyceride-rich lipoproteins are an independent
risk factor for atherosclerosis.
Methods and Results—The correlation of responses of
coronary arterial diameter (quantitative
coronary angiography) and coronary blood flow
(intracoronary flow wire technique) to intracoronary
infusion of acetylcholine (10 and 50 µg/min) with coronary
risk factors including remnant lipoprotein levels was statistically
analyzed in 106 consecutive subjects with normal
coronary angiograms. Remnant lipoproteins were isolated from
fasting blood with an immunoaffinity mixed gel containing
anti–apolipoprotein (apo) A-1 and anti–apoB-100 monoclonal
antibodies. In multivariate stepwise regression
analysis, remnant lipoprotein levels had the most significant
correlation with abnormal epicardial coronary vasomotor
responses to acetylcholine infusion, reflected by impaired dilation or
constriction of the epicardial coronary arteries, and the
levels also had an inverse and independent correlation with the
coronary blood flow increase in response to acetylcholine. In a
subgroup of 53 consecutive subjects, constrictor responses of
epicardial coronary diameters to intracoronary infusion
of
NG-monomethyl-L-arginine
(50 µmol/min for 4 minutes) at baseline, reflecting the presence
of coronary nitric oxide bioactivity, had an inverse and
independent correlation with remnant lipoprotein levels by use of
multivariate analysis.
Conclusions—Remnant lipoprotein levels were independently
associated with abnormal endothelium-dependent
vasomotor function in large and resistance coronary arteries in
humans, indicating that remnant lipoproteins may impair
endothelial vasomotor function in human
coronary arteries. The decrease in coronary nitric
oxide bioactivity may be responsible in part for the
inhibitory effects of remnant lipoproteins.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Association of Remnant Lipoprotein Levels With Impairment of Endothelium-Dependent Vasomotor Function in Human Coronary Arteries
Key Words: acetylcholine • lipoproteins • endothelium-derived factors • endothelium • hyperlipoproteinemia
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