Abstract:
OBJECTIVES:We investigated the influence of lipoprotein(a) [Lp(a)] serum levels on different endothelium-dependent vasodilator stimuli representing different mechanisms of endothelium-dependent vasodilation. BACKGROUND:Lp(a) is an independent predictor for the development and progression of coronary artery disease. Impairment of endothelium-dependent vasodilation of epicardial arteries has been shown in patients with high levels of Lp(a). METHODS:In 108 patients with angiographically normal or minimally diseased coronary vessels, vasomotor responses to acetylcholine, cold pressor testing, increased blood flow and nitroglycerin were assessed. RESULTS:Lp(a) levels > or = 30 mg/dl were associated with significant dose-dependent enhancement of the vasoconstrictor response to acetylcholine [receptor-mediated vasodilation, p = 0.002; acetylcholine 10(-6) mol/liter, -29 +/- 21% vasoconstriction with Lp(a) levels > or = 30 mg/dl vs, -5.6 +/- 25% with Lp(a) levels < 30 mg/dl]. In addition, vasoconstrictor response to cold pressor test (receptor- and flow-mediated vasodilation) was significantly enhanced in patients with Lp(a) levels > or = 30 mg/dl (-13 +/- 12% vs. 1.2 +/- 16%, p = 0.005). In contrast, strictly endothelium-dependent, but non-receptor-mediated, flow-dependent dilation and endothelium-independent dilation with nitroglycerin were not compromised. Linear regression analysis revealed an inverse relation between Lp(a) and both acetylcholine-induced (r = -0.34, p = 0.0007) and cold pressor test-induced (r = -0.44, p = 0.0001) vasodilation. By multivariate analysis, Lp(a) was a strong and independent predictor of paradoxic vasoconstriction only in response to acetylcholine and cold pressor testing. Impairment of coronary blood flow increase in patients with Lp(a) levels > or = 30 mg/dl did not reach statistical significance. CONCLUSIONS:High Lp(a) levels are associated with a selective impairment of vasodilator capacity of receptor-mediated endothelial stimuli. Impaired dilator capacity of the coronary circulation associated with elevated Lp(a) levels may contribute to the pathogenesis of myocardial ischemia in response to trigger mechanisms involving receptor-mediated stimulation such as sympathetic activation.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Schachinger V,Halle M,Minners J,Berg A,Zeiher AMdoi
10.1016/s0735-1097(97)00237-4subject
Has Abstractpub_date
1997-10-01 00:00:00pages
927-34issue
4eissn
0735-1097issn
1558-3597pii
S0735-1097(97)00237-4journal_volume
30pub_type
杂志文章abstract:OBJECTIVES:The aim of this study was to quantify and compare effective doses from conventional angiography and multislice computed tomography (MSCT) coronary angiography using a 16-slice scanner. BACKGROUND:Multislice computed tomography is now a viable modality for cardiac imaging. However, for any diagnostic use of ...
journal_title:Journal of the American College of Cardiology
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更新日期:2006-05-02 00:00:00
abstract::The recently published American College of Cardiology/American Heart Association/American College of Physicians Clinical Competency Statement for cardiac computed tomography/cardiac magnetic resonance (CCT/CMR) will be of great value to hospital medical staff organizations that grant privileges in the exciting new fie...
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journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:This study was undertaken to determine the roles of serum fibrinogen and residual platelet reactivity after clopidogrel pre-treatment on ischemic events after elective percutaneous coronary intervention (PCI). BACKGROUND:Both elevated serum fibrinogen and high platelet reactivity with thienopyridines are as...
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abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB), beta-blockers and statins are recommended after acute myocardial infarction (AMI). Patients may adhere to some, but not all, therapies. OBJECTIVES:The authors investigated the effect of tradeoffs in adherence to ACE inhib...
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更新日期:2017-09-26 00:00:00
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更新日期:2009-09-22 00:00:00
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更新日期:2021-01-05 00:00:00
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doi:10.1016/0735-1097(96)00229-x
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更新日期:2016-10-18 00:00:00
abstract:OBJECTIVES:We report our initial experience with percutaneous pulmonary valve replacement in animals with large pulmonary trunks, using a modified percutaneous approach. BACKGROUND:Percutaneous pulmonary valve replacement has recently been introduced, and early clinical experience has been reported. This technique is ...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2003.10.037
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(83)80244-7
更新日期:1983-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0735-1097(96)00583-9
更新日期:1997-03-15 00:00:00
abstract::Cardiac electrophysiologic alterations were evaluated 1 to 8 months after partial supracoronary aortic constriction in cats. This procedure induced left ventricular systolic hypertension and hypertrophy with marked connective tissue infiltration. In situ, premature ventricular complexes were observed during or after v...
journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2004.01.030
更新日期:2004-05-19 00:00:00
abstract::The incidence of intracoronary thrombus and the effects of thrombolytic therapy were studied in 41 patients with unstable angina. All patients underwent coronary angiography 2 to 69 h (mean 19) after their last attack of chest pain. Immediately after angiography, 21 patients received intracoronary streptokinase (250,0...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(88)90398-1
更新日期:1988-08-01 00:00:00
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更新日期:2005-10-04 00:00:00
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更新日期:1998-09-01 00:00:00
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更新日期:2013-11-12 00:00:00
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更新日期:2003-02-19 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1983-05-01 00:00:00
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更新日期:2004-10-19 00:00:00
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更新日期:2001-08-01 00:00:00
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更新日期:2003-07-02 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1990-08-01 00:00:00
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更新日期:1999-01-01 00:00:00