The Relationship between Plasma Endothelin‐1, Nitric Oxide Levels, and Heart Rate Variability in Patients with Coronary Slow Flow

Pekdemir, Haşan; Cicek, Dilek; Çamsarı, Ahmet; Akkuş, Mehmet Ali; Cin, Veli Gökhan; Döven, Oben; Parmaksiz, H. Tuncay; Katırcıbaşı, Mahmut Tuna; Özcan, İsmail Türkay

doi:10.1111/j.1542-474x.2004.91522.x

Cited by 25 publications

(22 citation statements)

References 45 publications

(55 reference statements)

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“…Aldosterone blockade has important effects on the production of reactive oxygen species (ROS) by reducing NAD(P)H oxidase in the vascular wall and myocardium, and oxidized low‐density lipoprotein cholesterol in circulating macrophages [12,13]. The production of ROS and the consequent destruction of nitric oxide have been shown to increase the release of norepinephrine from sympathetic nerve terminals and decrease heart rate variability [14]. Restoration of nitric oxide reduces norepinephrine release, improves heart rate variability, and baroreceptor function [15].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ≤30%

Pitt

Gheorghiade

Zannad

et al. 2006

European J of Heart Fail

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Aims: Because of the prognostic importance of LV dysfunction following an AMI and the increasing use of electrical and/or mechanical interventions in patients with LV systolic dysfunction, this retrospective analysis of EPHESUS patients with LVEF 30% at baseline was conducted to determine the value of eplerenone in this setting. Methods and results: In EPHESUS, 6632 patients with LVEF 40% and clinical heart failure (HF) post-AMI who were receiving standard therapy were randomized to eplerenone 25 mg/day titrated to 50 mg/day or placebo for a mean follow-up of 16 months. Treatment with eplerenone in the subgroup of patients with LVEF 30% (N = 2106) resulted in relative risk reductions of 21% versus placebo in both allcause mortality ( P = 0.012) and cardiovascular (CV) mortality/CV hospitalization ( P = 0.001), and 23% for CV mortality ( P = 0.008). The relative risk of sudden cardiac death (SCD) was reduced 33% ( P = 0.01) and HF mortality/HF hospitalization was reduced 25% ( P = 0.005) with eplerenone compared with placebo. Within 30 days of randomization, eplerenone resulted in relative risk reductions of 43% for all-cause mortality ( P = 0.002), 29% for CV mortality/CV hospitalization ( P = 0.006), and 58% for SCD ( P = 0.008). Conclusions: Treatment with eplerenone plus standard therapy in patients with post-AMI HF and LVEF 30% provided significant incremental benefits in reducing both early and late mortality and morbidity.

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Section: Discussionmentioning

confidence: 99%

Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ≤30%

Pitt

Gheorghiade

Zannad

et al. 2006

European J of Heart Fail

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“…Endothelial dysfunction detected by elevated levels of different factors is noted among patients with coronary slow-flow phenomenon [58]. Elevated levels of plasma endothelin-1, asymmetric dimethylarginine (ADMA), plasma adhesion molecules [intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin)], homocysteine, C-reactive protein (CRP), interleukin-6, noradrenaline and decreased levels of plasma nitric oxide identified in the setting of coronary slow-flow phenomenon have been correlated with the corrected TFC [59][60][61][62][63].…”

Section: Tfc In the Assessment Of Endothelial Functionmentioning

confidence: 98%

Use of the TIMI frame count in the assessment of coronary artery blood flow and microvascular function over the past 15 years

Kunadian

Harrigan

Zorkun

et al. 2008

J Thromb Thrombolysis

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“…Studies have shown an imbalance between the release of nitric oxide (vasodilator) and endothelin-1 (vasoconstrictor) and higher baseline levels of endothelin-1 in the plasma of subjects with SCF [6,19,20,27]. The correlation of a high hematocrit with SCF might be because increased blood viscosity impairs the endothelial release of vasoactive substances, and the imbalance between the release of nitric oxide and endothelin-1 may have a pathophysiologic role in SCF.…”

Section: Discussionmentioning

confidence: 99%

Correlation between the hematocrit and slow coronary flow

Wang

Zhang

Cheng

et al. 2014

Clinical Hemorheology and Microcirculation

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BACKGROUND: Whether the hematocrit is implicated in the pathogenesis of slow coronary flow (SCF) is not known. METHODS: To evaluate the correlation between the hematocrit and SCF, we studied 367 patients with angiographically near-normal coronary arteries. They were divided into four quartiles based on the hematocrit. The corrected thrombolysis in myocardial infarction frame count (TFC) was used to document velocity of coronary flow. RESULTS: From the first through to the fourth quartile, the percentage of males and those who smoked as well as serum levels of creatinine, uric acid and triglyceride increased (p < 0.001), whereas the age and level of high-density lipoprotein-cholesterol decreased (p < 0.05). The proportions of SCF in the quartiles increased (55.4, 60.9, 77.2 and 85.7%, respectively, p < 0.001). Multivariate analyses revealed that the corrected TFC for the left anterior descending artery (LAD) (p < 0.001; B = 0.065; 95% confidence interval (CI), 0.038-0.093; beta = 0.199) and the proportion of SCF in the LAD (p < 0.001; B = 1.343; 95% CI 0.704-1.983; beta = 0.174) were correlated with the hematocrit after adjustment for confounding factors. CONCLUSION: The hematocrit is positively correlated with the corrected TFC for the LAD, which suggested that an increase in the hematocrit may contribute to the pathophysiology of SCF.

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The Relationship between Plasma Endothelin‐1, Nitric Oxide Levels, and Heart Rate Variability in Patients with Coronary Slow Flow

Abstract: The present study demonstrated that in patients with CSF, both increased plasma ET-1, decreased plasma NOx and diffuse atherosclerosis may cause the decrease in HRV by effecting myocardial blood flow.

Cited by 25 publications

References 45 publications

Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ≤30%

Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ≤30%

Use of the TIMI frame count in the assessment of coronary artery blood flow and microvascular function over the past 15 years

Correlation between the hematocrit and slow coronary flow

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