The effects of dipyridamole stress test on plasma levels of soluble adhesion molecules intracellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin and L-selectin in patients with ischemic heart disease and patients with syndrome X

Background Adhesion of activated leukocytes to the endothelium as a result of myocardial ischemia/reperfusion has been shown to be involved in the dev elopment of tissue injury Leukocyte adhesion to the endothelium occurs via adhesion molecules expressed on the surface of both cell types. Upon cell a ctivation these proteins may be released into the circulation and measured in a soluble form. Aim To verify whether the dipyridamole stress test, performed in patients w ith ischemic heart disease (IHD) and in patients with syndrome X, modifies plasma levels of the soluble adhesion molecules vascular cell adhesion mole cule-1 (VCAM-1), intracellular adhesion molecule-1 (ICAM-1), E-selectin and L-selectin. Methods Plasma levels of the soluble endothelial adhesion molecules ICAM-1, VCAM-1 and E-selectin, as well as of the soluble leukocyte adhesion molecul e L-selectin, were measured in venous blood samples taken before and 7 min after administration of dipyridamole in patients with IHD, patients with sy ndrome X and healthy individuals. Myocardial perfusion was evaluated using single photon emission tomography. The plasma levels of soluble VCAM-1, ICA M-1, E-selectin and L-selectin were all measured using enzyme-linked immuno sorbent assays. Results After infusion of dipyridamole, plasma levels of ICAM-1 increased s ignificantly in patients with IHD, whereas they remained unchanged in patie nts with syndrome X and in the control group. In patients with IHD, the ini tial plasma levels of VCAM-1, E-selectin and L-selectin, before administrat ion of dipyridamole, were higher than those observed in patients with syndr ome X and than those in the control group. Plasma levels of soluble VCAM-1, E-selectin and L-selectin decreased significantly in patients with IHD fol lowing the dipyridamole stress test, whereas they remained unchanged in pat ients with syndrome X, and in the control group. Conclusion In patients with IHD, administration of dipyridamole induces myo cardial ischemia resulting in modification of plasma levels of the soluble adhesion molecules. Coronary Artery Di's 10:235-240 (C) 1999 Lippincott Wil liams & Wilkins.