Author + information
- Received July 13, 2009
- Revision received April 13, 2010
- Accepted May 1, 2010
- Published online July 1, 2010.
- Mieke van den Heuvel, MD, MSc⁎,†,
- Oana Sorop, PhD⁎,
- Wendy W. Batenburg, PhD†,
- Charlotte L. Bakker, BSc⁎,
- René de Vries, BSc†,
- Sietse Jan Koopmans, PhD‡,
- Heleen M.M. van Beusekom, PhD⁎,
- Dirk J. Duncker, MD, PhD⁎,
- A.H. Jan Danser, PhD† and
- Willem J. van der Giessen, MD, PhD⁎,§,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Willem J. van der Giessen, Erasmus University Medical Center, Thoraxcenter, Room Ee2393, ‘s-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
Objectives The aim of this study was to compare the effects of single drug-eluting stents (DES) on porcine coronary function distal to the stent in vivo and in vitro.
Background The mechanism of endothelial dysfunction occurring in human coronary conduit arteries up to 9 months after DES implantation is unknown.
Methods A sirolimus-eluting stent (SES), paclitaxel-eluting stent (PES), and a bare-metal stent (BMS) were implanted in the 3 coronary arteries of 11 pigs. After 5 weeks, in vivo responses in distal coronary flow to different doses of bradykinin (BK) and nitrates were measured. In vitro, vasodilation to BK and nitrates, as well as vasoconstriction to endothelin (ET)-1 were assessed in both distal coronary conduit and small arteries. In addition, contributions of nitric oxide (NO) and endothelium-derived hyperpolarizing factors (EDHFs) and cyclic guanosine monophosphate (cGMP) responses to BK-stimulation were determined in vitro.
Results Both DES did not alter in vivo distal vasomotion. In vitro distal conduit and small arterial responses to BK were also unaltered; DES did not alter the BK-induced increase in cGMP. However, after NO synthase blockade, PES showed a reduced BK-response in distal small arteries as compared with BMS and SES (p < 0.05). The ET-1–induced vasoconstriction and vascular smooth muscle cell function were unaltered.
Conclusions In this study of single stenting in healthy porcine coronaries for 5 weeks, SES did not affect distal coronary vascular function, whereas PES altered distal endothelial function of small arteries under conditions of reduced NO bioavailability. Therefore, specifically the EDH-component of microvascular function seems affected by PES.
- drug-eluting stent
- endothelial function
- endothelium derived hyperpolarizing factors
- Received July 13, 2009.
- Revision received April 13, 2010.
- Accepted May 1, 2010.
- American College of Cardiology Foundation