Acute endothelin-A receptor antagonism prevents normal reduction of myocardial ischemia on repeated balloon inflations during angioplasty

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dc.contributor.authorKyriakides, Z. S.en
dc.contributor.authorKremastinos, D. T.en
dc.contributor.authorKolettis, T. M.en
dc.contributor.authorTasouli, A.en
dc.contributor.authorAntoniadis, A.en
dc.contributor.authorWebb, D. J.en
dc.date.accessioned2015-11-24T19:38:04Z
dc.date.available2015-11-24T19:38:04Z
dc.identifier.issn1524-4539-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/24106
dc.rightsDefault Licence-
dc.subject*Angioplasty, Balloon, Coronaryen
dc.subjectAntihypertensive Agents/*pharmacologyen
dc.subjectBlood Pressure/drug effectsen
dc.subjectCollateral Circulation/drug effectsen
dc.subjectCoronary Angiographyen
dc.subjectCoronary Vessels/drug effectsen
dc.subjectElectrocardiography/methodsen
dc.subjectFemaleen
dc.subjectHeart Rate/drug effectsen
dc.subjectHumansen
dc.subjectInfusions, Intra-Arterialen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMyocardial Ischemia/*metabolism/radiography/surgeryen
dc.subjectPain Measurement/drug effectsen
dc.subjectPeptides, Cyclic/*pharmacologyen
dc.subjectReceptor, Endothelin Aen
dc.subjectReceptors, Endothelin/*antagonists & inhibitors/metabolismen
dc.subjectTreatment Outcomeen
dc.titleAcute endothelin-A receptor antagonism prevents normal reduction of myocardial ischemia on repeated balloon inflations during angioplastyen
heal.abstractBACKGROUND: Myocardial ischemia and reperfusion are associated with increased production of endothelin (ET)-1. METHODS AND RESULTS: We examined the effects of BQ-123, a selective ET(A) receptor antagonist, in 80 patients. All patients were randomly allocated to an intracoronary infusion of saline or BQ-123 (6 micromol/L over 20 minutes). The reference group consisted of 20 patients undergoing coronary angiography. BQ-123 produced a 10% (P:<0.005) increase in distal coronary artery diameter. The main study group consisted of 30 patients undergoing coronary angioplasty. All patients underwent a minimum of 3 balloon inflations (BIs). Surface and intracoronary electrocardiographic ST-segment shift as well as pain score were recorded at the end of each BI. BQ-123 or saline was given by intracoronary infusion between the second and the third BI in random allocation. In the saline group, intracoronary ST-elevation decreased from 1.26+/-0.55 mV during the first BI to 0.77+/-0.56 mV during the third BI (P:<0.05) and the surface ST elevation decreased from 0.20+/-0.15 to 0.10+/-0.07 mV (P:<0.05). In the BQ-123 group, the respective values were 1.22+/-0.48 mV and 1.13+/-0.62 mV (intracoronary) and 0.17+/-0.18 and 0.17+/-0.21 mV (surface) (both P:=NS). The decrease in pain score was significantly higher in the saline group (F:=5.97, P:=0.004). In 30 patients (collateral circulation group), the angioplasty protocol was repeated with the use of a pressure guide wire. BQ-123 produced a significant (F:=3.30, P:=0.04) decrease in coronary wedge pressure. CONCLUSIONS: Acute ET(A) receptor antagonism prevents the normal reduction of myocardial ischemia on repeated BIs during angioplasty. This may be explained by a "steal" effect through coronary collaterals.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/11034942-
heal.journalNameCirculationen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2000-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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