Thromb Haemost 2007; 97(04): 642-649
DOI: 10.1160/TH06-08-0479
Cardiovascular Biology and Cell Signalling
Schattauer GmbH

Active endothelin is an important vasoconstrictor in acute coronary thrombi

Christopher Adlbrecht
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Diana Bonderman
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Christian Plass
2   2 Center of Physiology and Pathophysiology, and the Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
,
Johannes Jakowitsch
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Gilbert Beran
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Wolfgang Sperker
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Peter Siostrzonek
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Dietmar Glogar
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Gerald Maurer
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
,
Irene M. Lang
1   Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology
› Author Affiliations
Financial support: This research was supported by FWFS9406-B11 (to IML).
Further Information

Publication History

Received 30 August 2006

Accepted after resubmission 08 February 2007

Publication Date:
24 November 2017 (online)

Zoom Image

Summary

Acute coronary syndrome is characterized by compromised blood flow at the epicardial and microvascular levels. We have previously shown that thrombectomy in ST-elevation myocardial infarction (STEMI) accelerates ST-segment resolution, possibly by preventing distal embolization. We hypothesized that thrombus constituents contribute to microcirculatory dysfunction. Therefore, we analyzed the molecular and cellular composition of acute coronary thrombi, and correlated vasoconstrictive mediators with the magnitude of ST-segment resolution within one hour of percutaneous coronary intervention (PCI). Fresh coronary thrombi were retrieved in 35 consecutive STEMI patients who were treated with the X-Sizer thrombectomy catheter, and thrombus cell counts and vasoconstrictor concentrations were assessed. Twelve-lead ECG recordings were analyzed prior to and one hour after PCI. Concentration of endothelin (ET) was 20.0 (7.9–52.2) fmol/ml in thrombus compared with 0.1 (0.1–0.3) fmol/ml in corresponding peripheral plasma (p<0.0001), representing a selective 280 (70.0–510.0)- fold enrichment, exceeding enrichment of noradrenaline, angiotensin II and serotonin. Human coronary thrombus homogenates exerted vasoconstriction of porcine coronary artery rings that was inhibited by the dual ET receptor blocker tezosentan. Extracted ET (r=0.523 p=0.026) and number of leukocytes (r=0.555 p=0.017) were correlated with the magnitude of STsegment resolution. In conclusion, the amount of active ET and white blood cells aspirated from STEMI target vessels correlated with improvement of territorial microcirculatory function as illustrated by enhanced ST-segment resolution.