29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation, Antalya, Turkey, 26 - 29 October 2013, vol.62
Atherosclerosis is a systemic disease which effects large and medium sized arteries besides coronary arteries. Atherosclerosis and associated diseases are the leading cause of death all over the world. It is known that endothelial dysfunction already starts before atherosclerotic involvement of coronary arteries. To diagnose atherosclerosis before organ damage has occured is important. The aim of the study is to evaluate the relationship between endothelial dysfunction and serum endothelin-1 levels, small artery elasticity, coronary artery disease severity and also to seek an answer if endothelin-1 antagonists may be benefical for cardiac Syndrome X or not.
Patients with chest pain were evaluated with exercise stress test or myocardial perfusion scintigraphy. Then ischemia deteceted patients underwent elective coronary angiography. Using ELISA method serum endothelin-1 levels of all patients were measured and a radial artery tonometer was used to measure arterial elasticity of all patients. The patients were grouped according to coronary artery disease history, ischemia existence and coronary angiogram results. The groups were compared with regards to serum endothelin-1 level, small artery elasticity and Gensini scores.
In the study group, 50 patients (62,5%) were male and 30 (37,5%) were female and the average age was 58,4 ±10,7 years. Twenty six (32,5%) of the patients had coronary artery disease history. Ischemia was present in 55 (68%) patients. Critical coronary lesions were present in 21 (38%) patients who underwent coronary angiography. Median serum endothelin-1 level was 18,9 ng/L (8,5-134,9 ng/L) in patients with ischemia and 14,8 ng/L (8,4-41,5 ng/L) in patients without ischemia. Serum endothelin-1 level of ischemic patients was higher (p=0.045). There wasn't a statistically significant relationship between serum endothelin- 1 levels and coronary artey disease history, small artery elasticity, Gensini scores.
Because of serum endothelin-1 level of patients without coronary artery disease history but with ischemia and normal coronary angiograms was higher than non-ischemic patients, it is assumed that endothelin-1 antagonists may be benefical for cardiac Syndrome X. To support this, there is a need for large prospective population based studies.