Author + information
- Received October 30, 2011
- Revision received March 7, 2012
- Accepted March 29, 2012
- Published online July 1, 2012.
- Christian A. Plass, MD⁎,
- Inna Sabdyusheva-Litschauer, MSc⁎,
- Andreas Bernhart, MD⁎,
- Eslam Samaha, MD†,
- Örs Petnehazy, PhD‡,
- Eszter Szentirmai, VMD‡,
- Zsolt Petrási, PhD‡,
- Victor Lamin, MSc⁎,
- Noemi Pavo, MD, MSc⁎,
- Noemi Nyolczas, MD⁎,
- András Jakab, MD§,
- Zsolt Murlasits, PhD∥,
- Jutta Bergler-Klein, MD⁎,
- Gerald Maurer, MD⁎ and
- Mariann Gyöngyösi, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Mariann Gyöngyösi, Department of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
Objectives This study sought to determine the time dependency of the endothelium-dependent and -independent vascular responses after percutaneous coronary intervention (PCI) with drug-eluting (DEB) or plain balloons, bare-metal (BMS), and drug-eluting (DES) stents, or controls.
Background Long-term endothelial dysfunction after DES implantation is associated with delayed healing and late thrombosis.
Methods Domestic pigs underwent PCI using DEB or plain balloon, BMS, or DES. The dilated and stented segments, and the proximal reference segments of stents and control arteries were explanted at 5-h, 24-h, 1-week, and 1-month follow-up (FUP). Endothelin-induced vasoconstriction and endothelium-dependent and -independent vasodilation of the arterial segments were determined in vitro and were related to histological results.
Results DES- and BMS-treated arteries showed proneness to vasoconstriction 5 h post-PCI. The endothelium-dependent vasodilation was profoundly (p < 0.05) impaired early after PCI (9.8 ± 3.7%, 13.4 ± 9.2%, 5.7 ± 5.3%, and 7.6 ± 4.7% using plain balloon, DEB, BMS, and DES, respectively), as compared with controls (49.6 ± 9.5%), with slow recovery. In contrast to DES, the endothelium-related vasodilation of vessels treated with plain balloon, DEB, and BMS was increased at 1 month, suggesting enhanced endogenous nitric oxide production of the neointima. The endothelium-independent (vascular smooth muscle–related) vasodilation decreased significantly at 1 day, with slow normalization during FUP. All PCI-treated vessels exhibited imbalance between vasoconstriction–vasodilation, which was more pronounced in DES- and BMS-treated vessels. No correlation between histological parameters and vasomotor function was found, indicating complex interactions between the healing neoendothelium and smooth muscle post-PCI.
Conclusions Coronary arteries treated with plain balloon, DEB, BMS, and DES showed time-dependent loss of endothelial-dependent and -independent vasomotor function, with imbalanced contraction/dilation capacity.
- endothelium-dependent vasodilation
- percutaneous coronary intervention
- pre-clinical experiment
The study was supported by the Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria. The guiding catheters and the FemoSeal were donated by Medtronic Inc., Minneapolis, Minnesota, and St. Jude Medical, St. Paul, Minnesota. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 30, 2011.
- Revision received March 7, 2012.
- Accepted March 29, 2012.
- American College of Cardiology Foundation