Key result
Routine coronary catheterization yields viable endothelial cell cultures in ~43% of ANOCA patients.
Why the study?
Studying patient-derived endothelial cells in ANOCA remains challenging due to the limited availability of disease-specific endothelial samples.
This study establishes a feasible method to isolate and culture patient-derived endothelial cells from routine coronary catheterization material, enabling personalized in vitro models of ANOCA.
Establishes feasibility for patient-specific coronary endothelial models in ANOCA; leaves open translation to clinical practice.
BACKGROUND: Angina with nonobstructive coronary arteries (ANOCA) is a heterogeneous condition encompassing distinct endotypes representing different underlying pathophysiological mechanisms. Endothelial dysfunction is considered a central hallmark of ANOCA. However, studying patient-derived endothelial cells (ECs) remains challenging due to the limited availability of disease-specific endothelial samples. We therefore aimed to assess the feasibility of isolating and culturing ECs from catheterization material obtained during routine coronary function testing in ANOCA patients. METHODS: Catheterization material was collected from 79 ANOCA patients (84% female, age 58 ± 10 years) undergoing coronary function testing. ECs were isolated, expanded and characterized using immunostaining, flow cytometry, gene expression profiling and functional assays. RESULTS: EC isolation was successful in 43% of cases and resulted in 34 primary EC cultures that were expanded up to passage 10. Isolation success was independent of clinical or procedural characteristics. Isolated cells exhibited typical EC morphology and expressed EC markers confirmed by immunostaining, flow cytometry and gene expression analyses. EC marker gene expression remained largely stable over passages. However, stress- and defense-related gene expression programs increased over time, while proliferation-related processes decreased. Functional assays demonstrated that the coronary catheterization-derived ECs showed typical properties of wound healing, angiogenesis, activation responses upon stimuli and monocyte adhesion. CONCLUSIONS: This study demonstrates the feasibility of isolating and expanding ECs directly from catheterization material collected during routine coronary function testing in ANOCA patients. These patient-derived ECs retain characteristic endothelial features and functionality. This approach offers primary EC cultures to study the mechanisms underlying endothelial dysfunction in ANOCA.
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Jong et al. (2026) studied Angina with nonobstructive coronary arteries (ANOCA) (n=79). Endothelial cell isolation from catheterization material was evaluated on Successful isolation and culture of endothelial cells. Endothelial cell isolation from routine coronary catheterization material was successful in 43% of ANOCA patients, yielding primary cultures that retained endothelial features.
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