Ja. Gomez-hospital et al., Endothelial function in coronary segments previously treated with balloon angioplasty, REV ESP CAR, 53(11), 2000, pp. 1467-1473
Background. Coronary angioplasty leads to endothelial disruption and a furt
her rendotelization. The aim of our study was to determine the status of en
dothelial function in previously dilated coronary segments without restenos
is.
Methods. Endothelium-dependent vasomotion was analysed in twelve patients w
ith single vessel coronary disease six month after angioplasty by selective
intracoronary doses of acetylcholine (10(-6), 10(-5), 10(-4) M) in the pre
viously treated artery. The control group was made up of seven patients wit
h no evidence of significant coronary stenosis and without risk factors. Va
somotor response at the different doses of acetylcholine was determined by
quantitative coronary angiography.
Results. Endothelial function showed a global vasodilator response in the d
ilated segment at the maximum dose of acetylcholine (increase in lumen diam
eter 3.6 +/- 3.5%), similar to the response observed in the control group (
increase of luminal diameter 3 +/- 6%; p = NS). In particular, 8 patients (
67%) showed a normal endotelial function, while 4 patients (33%) showed a v
asoconstrictor response. A positive correlation was detected between the re
sponse to the maximun dose of acetylcholine and the percent of residual ste
nosis at 6 months of follow-up (r = 0.67; p = 0.02).
Conclusion. In patients treated with coronary angioplasty without restenosi
s, the dilated segments frequently showed normal endothelial function. Grea
ter residual stenosis at the dilated segment was associated with less impai
rment in endothelial function.