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.

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