Elevated serum endothelin-1 is an independent predictor of coronary microvascular dysfunction in non-obstructive territories in patients with coronary artery disease

Naya, Masanao; Aikawa, Tadao; Manabe, Osamu; Obara, Masahiko; Koyanagawa, Kazuhiro; Katoh, Chietsugu; Tamaki, Nagara

Elevated serum endothelin-1 is an independent predictor of coronary microvascular dysfunction in non-obstructive territories in patients with coronary artery disease

Naya, Masanao; Aikawa, Tadao; Manabe, Osamu et al.

Heart and vessels, 2021, 36(7), 917-923

Permalink : https://hdl.handle.net/2115/86234

このアイテムのアクセス数:426件（2026-01-19 06:00 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/86234
タイトル	Elevated serum endothelin-1 is an independent predictor of coronary microvascular dysfunction in non-obstructive territories in patients with coronary artery disease
著者	Naya, Masanao ; Aikawa, Tadao ; Manabe, Osamu ; Obara, Masahiko ; Koyanagawa, Kazuhiro ; Katoh, Chietsugu ; Tamaki, Nagara
e-Rad_Researcher 20455637 著者名 Naya, Masanao
e-Rad_Researcher 20795059 著者名 Aikawa, Tadao
e-Rad_Researcher 40443957 著者名 Manabe, Osamu
著者名 Obara, Masahiko
著者名 Koyanagawa, Kazuhiro
e-Rad_Researcher 10292012 著者名 Katoh, Chietsugu
e-Rad_Researcher 30171888 著者名 Tamaki, Nagara
言語	英語
キーワード	Endothelin-1
	Coronary microvascular dysfunction
	Coronary artery disease
発行日	2021-07
出版者	Springer
収録物名	Heart and vessels
巻(号)	36(7)
ページ	917-923
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	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
PISSN	0910-8327
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00380-020-01767-x