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In concomitant coronary and peripheral arterial disease, inflammation of the affected limbs predicts coronary artery endothelial dysfunction
- Source :
-
Atherosclerosis (00219150) . Dec2008, Vol. 201 Issue 2, p440-446. 7p. - Publication Year :
- 2008
-
Abstract
- Abstract: Background: In coronary artery disease (CAD), concomitant peripheral arterial disease (PAD) entails more severe coronary atherosclerosis. We investigated whether the inflammatory status of affected limbs impairs coronary artery endothelial function (CAEF). Methods: We measured the neutrophil myeloperoxidase content (NMPOxC) and plasma levels of interleukin-6 and C-reactive protein in the aorta, femoral vein, and coronary sinus of 22 CAD+PAD and 18 CAD-alone patients. CAEF was assessed by the cold pressure test. Human coronary artery endothelial cells (HCAECs) were incubated with serum from the femoral vein and aorta of CAD+PAD patients to determine whether blood leaving the affected limb activates HCAECs. Results: In CAD+PAD patients, NMPOxC was higher across the femoral circulation than across the coronary circulation (p <0.01); it was also higher than across healthy femoral circulation of CAD patients (p <0.01). These findings apply also to interleukin-6, but not to C-reactive protein. The transfemoral gradient of NMPOxC and interleukin-6 significantly correlated with CAEF. The NMPOxC/CAEF relationship was much greater after exercise (R =0.79, p <0.001), which increased neutrophil activation across the affected circulation. The post-exercise association remained significant after adjustment for potential confounders (p <0.01). Serum from the affected limb of CAD+PAD patients induced, in vitro, a significant release of MCP-1 from HCAECs versus serum from the aorta of the same patients (630 [550–740] vs. 547 [490–620]; p <0.05). Conclusions: In CAD+PAD, triggers from the affected circulation may activate the endothelium at distant sites. Thus, PAD, besides being a marker of cardiovascular risk, could exert a mechanistic function in CAD progression. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 00219150
- Volume :
- 201
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Atherosclerosis (00219150)
- Publication Type :
- Academic Journal
- Accession number :
- 35561541
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2008.01.014