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October 3, 1991New England Journal of Medicine957 citations

Circulating and Tissue Endothelin Immunoreactivity in Advanced Atherosclerosis

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ALAmir LermanBEBrooks S. EdwardsJHJohn W. Hallett

Key Result

Patients with symptomatic atherosclerosis had significantly higher mean plasma endothelin concentrations compared to normal subjects (3.2 vs 1.4 pmol/L; P<0.001).

Key Points

  • To assess plasma endothelin concentrations in individuals with symptomatic atherosclerosis and their correlation with disease severity.
  • Measured plasma endothelin levels in 100 normal subjects and 40 patients with atherosclerosis subtypes.
  • Performed immunohistochemical staining for endothelin in atherosclerotic vessel walls.
  • Normal subjects had a mean plasma endothelin concentration of 1.4 +/- 0.2 pmol/L with no age correlation (r=0.13, P=0.2).
  • Patients had a mean plasma endothelin concentration of 3.2 +/- 1.2 pmol/L (P<0.001) with a strong correlation to disease sites (r=0.89, P<0.001).
  • Endothelin-1-like immunoreactivity was found in vascular smooth muscle and endothelial cells.

Study Design

Type

Case-Control (n=140)

Structured PICO

Are plasma endothelin concentrations elevated in persons with symptomatic atherosclerosis compared to normal subjects?

P
Population
140 subjects: 40 patients with symptomatic atherosclerosis (14 aortic and peripheral vascular disease, 9 renovascular disease, 9 coronary artery disease, 8 carotid disease) and 100 normal subjects.
C
Comparator
100 normal subjects
O
Outcome
Plasma endothelin concentrationsurrogate

Plasma endothelin concentrations are significantly elevated in patients with symptomatic atherosclerosis and correlate with the extent of disease involvement, suggesting it may serve as a marker for arterial vascular disease.

Main Result

Absolute Event Rate: 3.2% vs 1.4%

p-value: p=<0.001

Limitations

  • Unclear whether endothelin participates in the atherogenic process or is merely released from damaged endothelial cells

Abstract

BACKGROUND: Atherosclerosis is characterized by endothelial injury and the proliferation of arterial smooth-muscle cells. The latter may be a result of the release of growth factors from the vessel wall; such growth factors may include an endothelium-derived vasoconstrictor for peptide with mitogenic properties. We tested the hypothesis that plasma endothelin concentrations are elevated in persons with symptomatic atherosclerosis, independently of age. METHODS: We measured plasma endothelin levels in 100 normal subjects and in 40 patients with atherosclerosis predominantly of the following types: aortic and peripheral vascular disease (14 patients), renovascular disease (9 patients) coronary artery disease (9 patients), and carotid disease (8 patients). We also performed immunohistochemical staining for endothelin in the walls of atherosclerotic vessels. RESULTS: In the normal subjects, the mean (+/- SD) plasma endothelin concentration was 1.4 +/- 0.2 pmol per liter, with no correlation between age and plasma endothelin concentration (r = 0.13, P = 0.2). In the patients with symptomatic atherosclerosis, the mean plasma endothelin concentration was 3.2 +/- 1.2 pmol per liter (P less than 0.001), and there was a significant correlation between plasma endothelin and the number of sites of disease involvement (r = 0.89, P less than 0.001). In the immunohistochemical studies, endothelin-1-like immunoreactivity was observed in vascular smooth muscle as well as in endothelial cells. CONCLUSIONS: Endothelin may be a marker for arterial vascular disease. Whether it participates in the atherogenic process or is merely released from damaged endothelial cells is unclear.

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Cite This Study

Lerman et al. (1991) conducted a case-control in Symptomatic atherosclerosis (n=140). Symptomatic atherosclerosis vs. Normal subjects was evaluated on Plasma endothelin concentration (pmol/L) (p=<0.001). Patients with symptomatic atherosclerosis had significantly higher mean plasma endothelin concentrations compared to normal subjects (3.2 vs 1.4 pmol/L; P<0.001).

synapsesocial.com/papers/6a16ff022fcf950e0005875fhttps://doi.org/10.1056/nejm199110033251404
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