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Elevated serum endothelin-1 is an independent predictor of coronary microvascular dysfunction in non-obstructive territories in patients with coronary artery disease
| Title: | Elevated serum endothelin-1 is an independent predictor of coronary microvascular dysfunction in non-obstructive territories in patients with coronary artery disease |
| Authors: | Naya, Masanao Browse this author →KAKEN DB | | Aikawa, Tadao Browse this author →KAKEN DB | | Manabe, Osamu Browse this author →KAKEN DB | | Obara, Masahiko Browse this author | | Koyanagawa, Kazuhiro Browse this author | | Katoh, Chietsugu Browse this author →KAKEN DB | | Tamaki, Nagara Browse this author →KAKEN DB |
| Keywords: | Endothelin-1 | | Coronary microvascular dysfunction | | Coronary artery disease |
| Issue Date: | Jul-2021 |
| Publisher: | Springer |
| Journal Title: | Heart and vessels |
| Volume: | 36 |
| Issue: | 7 |
| Start Page: | 917 |
| End Page: | 923 |
| Publisher DOI: | 10.1007/s00380-020-01767-x |
| Abstract: | Endothelin-1 contributes to the constrictor response of the coronary arteries in patients with ischemia with normal coronary arteries. There is thus increasing evidence that endothelin-1 plays a role in coronary microvascular dysfunction (CMD). We investigated whether elevated endothelin-1 is associated with CMD in patients with coronary artery disease (CAD). We prospectively studied 49 consecutive CAD patients with 1- or 2-vessel disease (age 71 +/- 10 years, 43 males). Myocardial blood flow (MBF) was measured by O-15-water PET/CT at rest and during stress, and the coronary flow reserve (CFR) was calculated by dividing the stress MBF by the rest MBF. A CFR of less than 2.0 in non-obstructive regions was defined as a marker of CMD. Eighteen out of 49 (37%) CAD patients had CMD. Endothelin-1 in patients with CMD was significantly higher than in those without CMD (2.27 +/- 0.81 vs. 1.64 +/- 0.48 pg/mL, P = 0.001). Accordingly, univariate ROC analysis showed that the continuous endothelin-1 levels significantly discriminated between the presence and absence of CMD (area under the curve = 0.746 [95%CI 0.592-0.899]). The dichotomous treatment of elevated endothelin-1 as 1.961 pg/mL or more yielded the optimal discriminatory capacity, with a sensitivity of 72.2% and a specificity of 71.0%. High endothelin-1 was still a significant predictor of CMD after adjusting for diabetes mellitus (odds ratio = 6.64 [1.75-25.22], P = 0.005). Endothelin-1 is associated with CMD in non-obstructive territories in patients with CAD, suggesting that endothelin-1 is a potential target for treating CMD in CAD patients. |
| Rights: | This is a post-peer-review, pre-copyedit version of an article published in Heart and vessels. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00380-020-01767-x |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/86234 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 納谷 昌直
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