Abstract
Aim: Although underlying mechanisms of coronary artery ectasia (CAE) are clearly unknown, endothelial dysfunction may be responsible for the coronary ectasia. Asymmetric dimethylarginine (ADMA) is the principal endogenous inhibitor of nitric oxide synthase and elevated levels of ADMA is considered to be a marker of endothelial dysfunction and increased risk of cardiovascular disease. Accordingly, we investigated serum ADMA levels in patients with CAE in comparison with participants having normal coronary artery. Method: This study consisted of 41 consecutive patients with angiographically proven normal coronary arteries with CAE and 48 controls with normal coronary arteries without coronary artery ectasia undergoing cardiac catheterization. Serum levels of ADMA were measured by Enzyme Linked Immunosorbent Assay. Result: Serum level of ADMA was significantly higher in CAE patients compared with controls (1.9±0.9 μmol/l vs. 1.1±0.7 μmol/l, respectively, p= 0.01). Serum ADMA levels was an independent predictor for CAE (OR= 1.486 [95% confidence interval (CI): 0.978–2.054; p= 0.03]). ADMA levels correlated with diffuse ectasia (p= 0.04). Conclusion: Our findings provide evidence to support the hypothesis that endothelial dysfunction may be an important factor in the pathogenesis of CAE.
Highlights
Coronary artery ectasia (CAE) has been defined as localized or diffuse dilation of the coronary arteries exceeding the 1.5 fold of normal adjacent segment in coronary angiography [1,2]
Our findings provide evidence to support the hypothesis that endothelial dysfunction may be an important factor in the pathogenesis of CAE
Bulgular: Kontrol grubuyla kıyaslandığında koroner arter ektazisi olan hastalarda serum Asymmetric dimethylarginine (ADMA) düzeyleri anlamlı olarak yüksek saptanmıştır. (1.9±0.9 μmol/l vs. 1.1±0.7 μmol/l, p= 0.01) Serum ADMA düzeyleri koroner arter ektazisi için bağımsız bir öngördürücü belirteçtir. (OR= 1.486 [95% (CI): 0.978–2.054; p= 0.03])
Summary
Coronary artery ectasia (CAE) has been defined as localized or diffuse dilation of the coronary arteries exceeding the 1.5 fold of normal adjacent segment in coronary angiography [1,2]. Coronary artery disease (CAD) is supposed to be responsible for more than 50% of coronary ectasia, the precise pathology of CAE is not clearly understood. The main coronary angiographic characteristics of CAE are impaired coronary blood flow, delayed antegrade coronary dye filling, segmental back flow phenomenon (milking phenomenon) and stasis with local deposition of dye in dilated coronary segments [5]. Recent reports have implicated aneurysmal coronary arteries seem to have impaired flow velocities, flow reserve and microvascular flow dynamics, which may lead to inducible myocardial ischemia even in the absence of epicardial obstructive disease [6,7]
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