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Title: Plasma endothelin-1 and adrenomedullin are associated with coronary artery function and cardiovascular outcomes in humans.
Austin Authors: Theuerle, James D ;Farouque, Omar ;Vasanthakumar, Sheran;Patel, Sheila K ;Burrell, Louise M ;Clark, David J ;Al-Fiadh, Ali H
Affiliation: Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Cardiology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2019 2019-04-02
Publication information: International journal of cardiology 2019; 291: 168-172
Abstract: Endothelin-1 (ET-1) is a vasoconstrictor associated with cardiovascular disease, whereas adrenomedullin (ADM) is a vasorelaxant with cardioprotective properties. We sought to determine the relationship between plasma ET-1 and ADM with coronary circulatory function and long-term major adverse cardiovascular events (MACE). Thirty-two patients undergoing coronary angiography for chest pain were recruited. Baseline plasma ET-1 and ADM levels were measured. The index of microcirculatory resistance (IMR), coronary flow mediated dilatation (cFMD) and coronary flow reserve (CFR) were measured in a non-obstructed coronary artery. Patients were assessed for MACE over a median period of 8.8 years. Plasma ET-1 levels correlated with IMR (r = 0.57; p < 0.01) and ADM levels correlated with CFR (r = 0.50; p = 0.04) and cFMD (r = 0.62; p = 0.01). After adjustment for age, gender and cardiovascular risk factors, the association between ADM and cFMD (β = 0.79; p < 0.01) and between ET-1 and IMR (β = 5.7; p = 0.01) remained significant. IMR was higher, although not statistically significant, in patients with long-term MACE (17.9 ± 5.3 vs. 13.1 ± 6.0 units; p = 0.14). In patients free of MACE, cFMD (9.3 ± 7.6 vs. 2.8 ± 5.0%; p = 0.01) and plasma ADM levels (7.6 ± 5.3 vs. 4.0 ± 1.9 pmol/L; p = 0.07) were higher. Plasma ET-1 and ADM were associated with measures of coronary microvascular and coronary conduit vessel function, respectively. Increased cFMD and elevated plasma ADM were associated with a cardioprotective effect.
DOI: 10.1016/j.ijcard.2019.04.008
ORCID: 0000-0002-0626-1899
Journal: International journal of cardiology
PubMed URL: 30987836
Type: Journal Article
Subjects: Adrenomedullin
Coronary flow mediated dilatation
Coronary microcirculation
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