Endocan expression correlated with total volume of coronary artery dilation in patients with coronary artery ectasia

Abstract

Introduction: Inflammation and angiogenesis disturbances are considered as factors contributing to the development of coronary artery ectasias (CAE). Endocan (endothelial cell-specific molecule-1-ESM-1) regulates both inflammatory and angiogenetic processes. However, there are no data about the correlation between endocan level and the severity of CAE measured with total volume of coronary artery dilation. Aim: To assess whether the severity of the inflammatory process measured as endocan concentration correlates with the total volume of CAE. Material and methods: We selected prospectively a total of 43 consecutive patients with coronary artery ectasia from 2240 patients who underwent coronary angiography in our center. Determination of endocan was performed by using the Human Endothelial cell-specific Molecule 1 (ECSM1/ENDOCAN) ELISA Kit. 3D QCA (three-dimensional quantitative coronary angiography) was used for coronary lesion and aneurysm quantification. The total volume of dilation was defined as the volume of all aneurysms and ectasias of coronary arteries in 1 patient. Results: The mean volume of all aneurysms in 1 patient was 677 ±878.7 mm 3. The total aneurysm volume was positively strongly correlated with endocan concentration (Pearson correlation coefficient: 0.811; 2-tailed p < 0.001). Conclusions: Endocan is a potential marker of vascular wall damage mainly as a result of inflammation in the course of atherosclerosis, but also vascular remodeling as a result of a disturbance of pro-and anti-angiogenic processes. Endocan level reflects the intensity of the above processes and therefore correlates with the severity of CAE, measured as the total volume of dilation.

Involvement of Angiogenesis in the Pathogenesis of Coronary Aneurysms

“…A previous study showed that the total aneurysm volume was positively correlated with endocan (endothelial cell-specific molecule-1—ESM-1) concentration. ESM-1 regulates both inflammatory and angiogenetic processes, being a potential marker of vascular wall damage resulting from inflammation and vascular remodeling as a result of a disturbance of pro and antiangiogenic processes [ 11 ]. Angiogenesis is also regulated by molecular mechanisms [ 7 , 12 ].…”

Invasive microvascular coronary circulation assessment in patients with coronary artery aneurysmal disease

“…Adverse vascular remodeling is considered to be a possible mechanism of CAAD development. [13][14][15] Therefore, assuming that the processes mentioned above involve the entire vascular bed, coronary microcirculation remodeling is thought to be a possible cause of CMD in CAAD patients. Moreover, a turbulent blood flow in aneurysms supports the development of thrombi, which may result in distal embolization and thus impair coronary microcirculation.…”

Three-dimensional reconstruction of conventional catheter angiography-identified coronary artery aneurysms and ectasias

“…Computed tomography angiography is today the #1 tool to obtain CAAE 3D characteristics [4]. CTA, however, it is not performed prior to CAG identification of CAAE but, rather, as a subsequent step in arbitrarily selected cases [9]. Importantly, CTA resolution is > 2-fold lower than that of CAG (≈ 0.5 vs. ≈ 0.2 mm) [6,7], and CTA is prone to gating-related (increased heart rate, arrhythmias) and calcifications-related artifacts [4].…”

“…For these reasons it would be of interest to employ 3D reconstructions as a potential replacement of CTA verification or as a guidance to selective CTA use. This is one of the major issues of interest today [9,10]; thus CAAE 3D reconstruction against CTA in a larger series of patients is required to fully validate this method.…”