ORIGINAL ARTICLES   

International Angiology 2000 March;19(1):14-17

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Treadmill exercise-induced release of endothelin-1 in patients with peripheral arterial occlusive disease at Fontaine stage IIb

Mangiafico R. A., Malatino L. S., Spada R. S., Santonocito M., Messina R., Dell’Arte S., Attinà T.

From the Institute of Clinica Medica “L. Condorelli”, University of Catania, Catania, Italy

Back­ground. Endo­the­lin-1 (ET-1) is an endo­the­lial vas­o­con­stric­tor mit­o­gen­ic pep­tide which is ­thought to be a mark­er of endo­the­lial dam­age and a poten­tial par­tic­i­pant in the path­o­phy­sio­log­i­cal pro­cess­es of the devel­op­ment of ath­e­ros­cle­rot­ic ­lesions and dis­ease ­states asso­ciat­ed with vaso­con­stric­tion and vasos­pasm.
Meth­ods. To inves­ti­gate the endo­the­lin-1 ­release in ­response to dynam­ic exer­cise in ­patients with periph­er­al arte­ri­al occlu­sive dis­ease (PAOD), plas­ma con­cen­tra­tions were deter­mined by radio­im­mu­noas­say in 16 ­patients (14 men, 2 women, mean age 56.2±8.1 years) with periph­er­al arte­ri­al occlu­sive dis­ease at Fon­taine stage IIb and in 10 con­trol sub­jects (8 men, 2 women, mean age 58.1±7.2 years) in nor­mal ­health dur­ing tread­mill test­ing (slope 5%, speed 3 km/hr). Blood sam­ples were col­lect­ed at rest from an ante­cu­bi­tal vein, at the onset of claud­i­ca­tion pain, and 10 min­utes after exer­cise.
­Results. Mean plas­ma endo­the­lin-1 con­cen­tra­tions dur­ing the ­stress test ­increased sig­nif­i­cant­ly in the ­patients with arte­ri­al dis­ease, ris­ing from basal val­ues of 4.4±0.6 pmol/L to val­ues of 8.9±0.7 pmol/L at the end of the test (p<0.0001), where­as it did not ­change sig­nif­i­cant­ly in con­trol sub­jects (ris­ing from 2.6±0.4 pmol/L to 2.7±0.5 pmol/L). Fur­ther, plas­ma endo­the­lin-1 in the ­patients with arte­ri­al dis­ease was at all times high­er than in the con­trol sub­jects (p<0.0001).
Con­clu­sions. In con­clu­sion, this study shows that in ­patients with periph­er­al arte­ri­al occlu­sive dis­ease, plas­ma endo­the­lin-1 increas­es after tread­mill exer­cise per­formed until claud­i­ca­tion pain super­venes. ­Raised endo­the­lin-1 could be a mark­er of ischaem­ic acute endo­the­lial dam­age and/or could con­trib­ute to ­increase the vas­cu­lar resis­tance in ischae­mic limbs of these ­patients dur­ing dynam­ic exer­cise by pro­mot­ing arte­ri­al/arter­i­o­lar vaso­con­stric­tion or vasos­pasm.