Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Endotheliumfunctional condition in patients withischemic heart disease associated with coronarystenting depending on implanted stent type

Abstract

We determined the differences of endothelium functional conditions in 77 patients with ischemic heart disease demanding routine coronary stenting, in terms of cirolimus-covered and common metal stents. We analyzed the dynamics of endothelium-dependent and endothelium-independent vasodilation indexes, biochemical markers for endothelium function, i.e. von Willebrand factor (vWFAg) and E-selectine for one year after the procedure. The results of the study showed that coronary artery stenting is accompanied by stable decrease in extent of endothelium-dependent vasodilation. Intensity and duration of this process depend on the stent type: cirolimus-covered stent implantation leads to higher duration and intensity of endothelium dysfunction compared with common stents. This becomes evident because of prolonged decrease in extent of endothelium-dependent vasodilation during one year after the performed procedure and higher vWF indexes (starting from 3rd month up to the end of the year) compared to common metal stents. Increase in vWF and E-selectine expression right after the procedure can be viewed as mechanisms being a part of local physical response from vascular wall to endovascular influence. Stable increase in vWF and endothelium-dependent vasodilation indexes during a yearly follow-up show prolonged dysfunctions and functional condition of endothelium which become systemic.

References

1. Barilli A., Visigalli R., Sala R. et al. In human endothelial cells rapamycin causes mTORC2 inhibition and impairs cell viability and function // Cardiovasc. Res. - 2008. - Vol. 78, № 3. - P. 563-571.
2. Blum A., Schneider D., Sobel B., Dauerman H. Endothelial dysfunction and inflammation after percutaneous coronary intervention // Am. J. Cardiol. - 2004. - Vol. 94, № 11. - P. 1420-1423.
3. Boos C., Balakrishnan B., Jessani S. Effects of percutaneous coronary intervention on peripheral venous blood circulating endothelial cells and plasma indices of endothelial damage/dysfunction // Chest. - 2007. - Vol. 132, № 6. - P. 1920-1926.
4. Callow A. D. Endothelial dysfunction in atherosclerosis // Vascul. Pharmacol. - 2002. - Vol. 38, № 5. - P. 257-258.
5. Caramori P., Lima V., Seidelin P. et al. Long-term endothelial dysfunction after coronary artery stenting // J. Am. Coll. Cardiol. - 1999. - Vol. 34, № 6. - P. 1675-1679.
6. Conway D., Pearce L., Chin B. et al. Prognostic value of plasma von Willebrand factor and soluble P-selectin as indices of endothelial damage and platelet activation in 994 patients with nonvalvular atrial fibrillation // Circulation. - 2003. - Vol. 107, № 25. - P. 3141-3145.
7. Farb A., Heller P., Shroff S. et al. Pathological analysis of local delivery of paclitaxel via a polymer-coated stent // Circulation. - 2001. - Vol. 104, № 4. - P. 473-479.
8. Fuke S., Maekawa K., Kawamoto K. et al. Impaired endothelial vasomotor function after sirolimus-eluting stent implantation // Circ. J. - 2007. - Vol. 71, № 2. - P. 220-225.
9. Hamid H., Coltart J. «Miracle stents» - a future without restenosis // Mcgill. J. Med. - 2007. - Vol. 10, № 2. - P. 105-111.
10. Hill R., Dundar Y., Bakhai A. et al. Drug-eluting stents: an early systematic review to inform policy // Eur. Heart J. - 2004. - Vol. 25, № 11. - P. 902-919.
11. Jeanmart H., Malo O., Carrier M. et al. Comparative study of cyclosporine and tacrolimus vs newer immunosuppressants mycophenolate mofetil and rapamycin on coronary endothelial function // J. Heart Lung Transplant. - 2002. - Vol. 21, № 9. - P. 990-998.
12. Kefer J., Galanti L., Desmet S. et al. Time course of release of inflammatory markers after coronary stenting: comparison between bare metal stent and sirolimus-eluting stent // Coron. Artery Dis. - 2005. - Vol. 16, № 8. - P. 505-509.
13. Kozinski M., Kubica J., Sukiennik A. et al. Periprocedural soluble P- and E-selectin levels fail as predictors of clinical restenosis in patients treated with elective coronary stenting // Int. J. Mol. Med. - 2007. - Vol. 19, № 1. - P. 187-195.
14. Malek A., Alper S., Izumo S. Hemodynamic shear stress and its role in atherosclerosis // JAMA. - 1999. - Vol. 282, № 21. - P. 2035-2042.
15. Mizia-Stec K. Cytokines and adhesive molecules in detection of endothelial dysfunction // Pharmacol. Rep. - 2006. - Vol. 58 (Suppl.). - P. 21-32.
16. Mizia-Stec K., Gsior Z., Zahorska-Markiewicz B. et al. Inflammatory markers in a 2-year follow-up of coronary artery disease // Heart Vessels. - 2006. - Vol. 21, № 5. - P. 302-308.
17. Moreno R., Fernбndez C., Hernбndez R. et al. Drug-eluting stent thrombosis: results from a pooled analysis including 10 randomized studies // J. Am. Coll. Cardiol. - 2005. - Vol. 45, № 6. - P. 954-959.
18. Shin D., Kim P., Seung K. et al. Drug-eluting stent implantation could be associated with long-term coronary endothelial dysfunction // Int. Heart J. - 2007. - Vol. 48, № 5. - P. 553-567
19. Suzuki T., Kopia G., Hayashi S. et al. Stent-based delivery of sirolimus reduces neointimal formation in a porcine coronary model // Circulation. - 2001. - Vol. 104, № 10. - P. 1188-1193.
20. Szmitko P., Wang C., Weisel R. et al. Biomarkers of vascular disease linking inflammation to endothelial activation: Part II // Circulation. - 2003. - Vol. 108, № 17. - P. 2041-2048.
21. Szmitko P., Wang C., Weisel R. et al. New markers of inflammation and endothelial cell activation: Part I // Circulation. - 2003. - Vol. 108, № 18. - P. 1917-1923.
22. Tesfamariam B. Local vascular toxicokinetics of stent-based drug delivery // Toxicol. Lett. - 2007. - Vol. 168, № 2. - P. 93-102.
23. Van Beusekom H., Whelan D., Hofma S. et al. Long-term endothelial dysfunction is more pronounced after stenting than after balloon angioplasty in porcine coronary arteries // J. Am. Coll. Cardiol. - 1998. - Vol. 32, № 4. - P. 1109-1117.
24. Verma S., Buchanan M., Anderson T. Endothelial function testing as a biomarker of vascular disease // Circulation. - 2003. - Vol. 108, № 17. - P. 2054-2059.
25. Weidinger F., McLenachan J., Cybulsky M. et al. Persistent dysfunction of regenerated endothelium after balloon angioplasty of rabbit iliac artery // Circulation. - 1990. - Vol. 81, № 5. - P. 1667-1679.
26. Yip H., Youssef A., Chua S. et al. Re-elevation of high-sensitivity C-reactive protein but not the von Willebrand Factor after withdrawing atorvastatin therapy in patients with unstable angina undergoing coronary artery stenting // Int. Heart J. - 2006. - Vol. 47, № 4. - P. 501-509.
27. Yoneyama K., Tsuboya A., Kogo M. et al. Predictors of restenosis after coronary artery stenting // Minerva Cardioangiol. - 2008. - Vol. 56, № 3. - P. 295-305.

 If you found mistakes, select text and press Alt+A