Chronic endothelial dysfunction after oversized coronary balloon angioplasty in pigs: A 12-week follow-up of coronary vasoreactivity in vivo and in vitro

Francisco A.H. Fonseca, Maria C.O. Izar, Valentin Fuster, Richard Gallo, Adrian Padurean, John T. Fallon, E. Neil Schachter, James H. Chesebro, Juan J. Badimon

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Previous studies have reported the development of vasoconstriction immediately after invasive coronary interventions. Other studies in animals have demonstrated that using oversized balloon angioplasty, vasospasm can be suppressed, even in the presence of endothelial denudation due to important structural alteration in vascular smooth muscle. The regenerated endothelium also appears to be impaired chronically by selective attenuation of in vitro endothelial dependent relaxation related to pertussis toxin-sensitive G proteins. The purpose of this investigation was to verify in vivo and in vitro vasoreactivity to bradykinin (BK) and serotonin (5-hydroxytryptamine; 5-HT) (endothelial dependent agonists) as well as to nitroglycerin (NTG) (exogenous nitric oxide donor) at different times after oversized balloon angioplasty intervention ranging from 1 h to 12 weeks, in normal porcine coronary arteries. BK-induced vasodilatation in vivo was impaired acutely, but it was restored after 4 weeks. Serotonin caused vasoconstriction in vivo that was significantly augmented after 12 weeks. Conversely, endothelium-dependent vasodilatation in vitro to BK and 5-HT remained attenuated during the whole period of follow-up. Finally, relaxation elicited by NTG was reduced in the in vivo experiment until the first week after the procedure. Histological analysis showed severe arterial injury, and complete recovery of endothelial coverage after 4 weeks. In conclusion, this experiment supports evidence for the occurrence of the acute attenuation of vasoresponsiveness and chronic endothelial dysfunction following overstretching coronary balloon angioplasty. Abnormal remodeling associated with the severity of injury may contribute to chronic endothelial dysfunction. Differences found between in vivo and in vitro studies also suggest that multiple endogenous influences present in the former can attenuate the greater endothelial dysfunction demonstrated by endothelial assessment in vitro.

Original languageEnglish
Pages (from-to)61-69
Number of pages9
JournalAtherosclerosis
Volume154
Issue number1
DOIs
StatePublished - 2001

Keywords

  • Balloon angioplasty
  • Invasive coronary inteerventions
  • Vasoconstriction

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