Coronary endothelial injury and cardiac angiotensin II in angina patients

Objective The aim of this study was to investigate the level of coronary endothelial injury and dysfunction, the variation of cardiac angiotensin Ⅱ(AngⅡ), and their correlations in patients with stable angina (SA) or unstable angina (UA). Methods The 20 patients with UA, 17 patients with SA and 18 patients excluding coronary heart disease (control) were studied. Blood samples were collected during percutaneous coronary intervention (PCI). We investigated the coronary endothelial injury and dysfunction by measuring the concentrations of nitric oxide (NO), endothelin (ET) and the number of circulating endothelial cells (CEC) in coronary sinus blood. The aorta-coronary sinus gradient was measured as cardiac AngⅡ.The AngⅡ concentration of peripheral blood was also measured. Results In angina patients, especially in UA patients,NO concentration in coronary sinus blood was lower, while ET concentration and CEC number were markedly higher than those in control group (P0.01, or P0.05). AngⅡ concentration in angina patients, especially in UA patients was higher than that in control group (P0.01, or P0.05). The coronary endothelial injury and dysfunction showed a positive correlation with cardiac AngⅡ concentration. No obvious correlation was seen between coronary endothelial injury and peripheral AngⅡ concentration. Conclusion In angina patients especially UA patients, the coronary endothelium is injured and the cardiac AngⅡ is activated obviously. The coronary endothelial injury and high expression of cardiac AngⅡ may affect each other. This may result in the aggravating lesion of coronary artery.