Key result
Patients with ischemic heart disease had significantly lower plasma nitric oxide levels compared to controls (23.51 vs 29.35 µM; p=0.049), while endothelin levels did not differ significantly.
Why the study?
Endothelial dysfunction reflects propensity to develop atherosclerosis, prompting investigation into whether endothelin-1 and nitric oxide levels contribute to its etiopathogenesis in ischemic heart disease.
Are serum levels of endothelin-1 and nitric oxide altered in patients with angiographically proven ischemic heart disease compared to controls?
Case-Control (n=100)
No
Are serum levels of endothelin-1 and nitric oxide altered in patients with angiographically proven ischemic heart disease compared to controls?
Patients with ischemic heart disease have significantly lower nitric oxide levels compared to controls, suggesting a role in endothelial dysfunction, though endothelin-1 levels were not significantly different.
Answers are grounded in this paper and cite their sources.
Lower nitric oxide was associated with ischemic heart disease; hypothesis-generating for endothelial dysfunction and should not yet change practice.
Introduction: Endothelial dysfunction is an imbalance in bioavailability of endothelium-derived relaxing (Nitric Oxide) and contracting factors (Endothelin). Studies have shown that NO has antiatherogenic property as it inhibits vascular smooth muscle contraction and proliferation, platelet aggregation and leukocyte adhesion. On the other hand, Endothelin-1 causes proliferation and vasoconstriction of myocytes resulting in elevated vascular tone thereby contributing to endothelial dysfunction. This dysfunction is a well-established response to cardiovascular risk factors and precedes the development of atherosclerosis. As a result, status of an endothelial dysfunction may reflect the propensity to develop atherosclerotic disease and may serve as a marker of an unfavourable cardiovascular prognosis. Materials and Methods: 50 cases of angiographically proven ischemic heart disease and 50 age and sex matched patients with no evidence of ischaemic heart disease on angiography were selected from G.B Pant Hospital, New Delhi, India. Serum levels of Endothelin were estimated by sandwich ELISA and nitric oxide levels by modified Griess reaction. Results: Serum levels of Endothelin were raised while nitric oxide levels were significantly reduced (p=0.049) in the cases as compared to controls. The mean plasma nitric oxide level in the study group (cases) was 23.51±13.48 µM and in the control group was 29.35±15.73 µM. The difference between the two was significant (p=0.049*). The mean plasma endothelin level in the study group was 3.04±1.37fmol/ml and in the control group was 2.95±1.70 fmol/ml. The difference between the two was not significant (p = 0.764). Conclusion: Higher Endothelin-1 and lower NO levels in cases suggest their role in causing endothelial dysfunction in ischemic heart disease patients. However, larger sample size is required to assess the role of Endothelin as a biomarker of endothelial dysfunction in patients of ischemic heart disease.
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Suri et al. (2018) conducted a case-control in Ischemic heart disease (n=100). Patients with ischemic heart disease had significantly lower plasma nitric oxide levels compared to controls (23.51 vs 29.35 µM; p=0.049), while endothelin levels did not differ significantly.
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