Clinical implications of assessing coronary flow velocity reserve and plasma endothelin-1 in hypertensive patients.

Abstract

Previous reports have indicated that hypertensive patients who have angina-like chest pain and normal coronary arteriograms have reduced coronary flow velocity reserve (CFVR) levels. In addition, elevated plasma endothelin-1 (ET-1) levels have been reported to be associated with microvascular angina. The purpose of this study was to evaluate the plasma ET-1 levels and CFVR in patients with chest pain but without coronary artery disease (CAD). A total of 66 patients were included in this study. CAD was ruled out by exercise stress test or coronary angiogram. Plasma ET-1 and CFVR measurements were performed in patients with (n=35) and without (n=31) a history of angina-like chest pain. CFVR was measured using adenosine-triphosphate stress transthoracic Doppler echocardiography. The mean ET-1 level was significantly higher and the CFVR was significantly lower in patients in the symptomatic group than in those in the asymptomatic group (ET-1: 3.85 +/- 1.24 pg/ml vs. 2.98 +/- 1.27 pg/ml, CFVR: 2.26 +/- 0.48 vs. 2.77 +/- 0.11, respectively). Plasma ET-1 level and CFVR were significantly correlated with each other (-r = 0.265, p = 0.033). Age, blood pressure, cardiovascular risk factors, and left ventricular mass index were similar between the two groups. The results of multiple regression analysis indicate that age (p = 0.008) and plasma ET-1 concentration (p = 0.031) had statistically independent associations with CFVR. Attenuated CFVR in the symptomatic hypertensive patients was associated with endothelial dysfunction, which results in elevated plasma ET-1 levels. The link between these two parameters may play a role in the genesis of chest pain in hypertensive patients without CAD.

• Authors: Hideki Fujii, Shin Takiuchi, Kei Kamide, Takeshi Horio, Shin-ichirou Niizuma, Norio Tanaka, Shuji Hashimoto, Satoshi Nakatani, Masafumi Fukagawa, Yuhei Kawano
• Journal: Hypertension research : official journal of the Japanese Society of Hypertension (Hypertens Res) Vol. 28 Issue 11 Pg. 911-6 (Nov 2005) ISSN: 0916-9636 [Print] England
• PMID: 16555580 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Endothelin-1

Topics

• Aged
• Blood Flow Velocity (physiology)
• Chest Pain (physiopathology)
• Coronary Circulation (physiology)
• Echocardiography
• Endothelin-1 (blood)
• Female
• Humans
• Hypertension (physiopathology)
• Male
• Middle Aged