Plasma endothelin levels as a function of coronary artery manipulation during balloon angioplasty and high-speed rotational atherectomy

This study was conducted to test the hypothesis that endothelin levels may be related to the coronary artery manipulation during balloon angioplasty (BA) or rotational atherectomy (RA). Blood endothelin levels were measured in 35 patients who underwent BA and in 11 patients who underwent RA followed by adjunctive balloon angioplasty. Arterial and venous levels were measured before, immediately after, and 24 h after the procedure. The levels were then related to the number of balloon inflations, the total inflation time and the maximal pressure in the balloon during inflation. There were no significant differences between groups or time periods. However, 24 h after BA the endothelin plasma levels in venous blood were directly related to the number of balloon inflations (r 3 0.49; P 3 0.03), to the total inflation time (r 3 0.67; P 3 0.005) and to the maximal inflation pressure (r 3 0.71; P 3 0.001). No such correlation was found in venous blood immediately after BA, either in arterial blood or in the RA group. It can be concluded that plasma endothelin levels do not change significantly after balloon angioplasty; however, venous endothelin levels 24 h after BA are related to procedural parameters, reflecting endothelial damage, which may determine the post-angioplasty late results.