VEIN PLASMA ENDOTHELIN-1 AND CYCLIC-GMP INCREASE DURING CORONARY ANGIOPLASTY IS RELATED TO MYOCARDIAL-ISCHEMIA

Endothelin-1 and cyclic guanosine monophosphate (c-GMP) peripheral vei n plasma levels increase during coronary angioplasty, but the reason f or this increase has not been elucidated. The purpose of this study wa s to investigate whether theses changes are related to myocardial isch aemia, or to mechanical artery injury induced during the procedure. Th irty-two patients with stable angina pectoris and a single lesion were studied. They were aged 56+/-8 and were undergoing balloon angioplast y. Eight arteries were totally occluded and 24 were partially occluded . Blood samples were drawn from a peripheral vein after coronary arter y engagement with the guiding catheter (baseline), after the first bal loon inflation, after the end of th procedure, and 4 h later. In the t otal occlusion group endothelin-1 increased by 7% (P ns), whereas in t he partial occlusion group it increased by 45% after the procedure (P< 0.001). c-GMP in the partial occlusion group increased by 41% (P<0.001 ) after the procedure whereas in the total occlusion group it increase d by 5% (P ns). Thus, the increase in endothelin-1 and c-GMP periphera l vein plasma levels after coronary angioplasty is related to myocardi al ischaemia rather than to mechanical artery injury.