Coronary atherosclerotic wall thickening and vascular reactivity in humans. Elevated high-density lipoprotein levels ameliorate abnormal vasoconstriction in early atherosclerosis

A M Zeiher, V Schächlinger, S H Hohnloser, B Saurbier, H Just
1994 Circulation  
Abnormal vascular reactivity represents a fundamental disturbance in vascular biology with the development of atherosclerosis. Because endothelial vasodilator function plays a pivotal role in controlling vasomotor tone, we hypothesized that atherosclerotic wall thickening might directly interfere with deficient endothelium-mediated dilation and thereby contribute to the abnormal reactivity of atherosclerotic arteries in vivo. Methods and Results In 26 patients without focal stenoses in the left
more » ... anterior descending coronary artery, acetylcholine (0.036 to 3.6 ,g/mL) was infused into the artery to evaluate endothelium-mediated vasodilation. Segmental vasomotor responses to acetylcholine were correlated with the local extent of atherosclerotic wall thickening quantitated by intracoronary ultrasound examination. Seventeen of the patients also underwent cold pressor testing to assess the vasoreactivity to sympathetic activation. The response of coronary artery segments to acetylcholine varied from 35% dilation to 52% constriction and demonstrated a segmental pattern, with dilation and constriction observed in different segments of the same artery. The vasomotor response to acetylcholine was closely correlated with the extent of local atherosclerotic wall thickening (r= -.82, P<.0001). Over the entire range of atherosclerotic wall thickening, segments from patients with elevated highdensity lipoprotein (HDL) cholesterol serum levels (>75th
doi:10.1161/01.cir.89.6.2525 pmid:8205660 fatcat:u2jwwsh4xzhplm346dibntop3a