- 作者：Mieke van den Heuvel ; MD ; MSc?/sup> ; &dagger ; ; Oana Sorop ; PhD?/sup> ; Wendy W. Batenburg ; PhD&dagger ; ; Charlotte L. Bakker ; BSc?/sup> ; René ; de Vries ; BSc&dagger ; ; Sietse Jan Koopmans ; PhD&Dagger ; ; Heleen M.M. van Beusekom ; PhD?/sup> ; Dirk J. Duncker ; MD ; PhD?/sup> ; A.H. Jan Danser ; PhD&dagger ; ; Willem J. van der Giessen ; MD ; PhD?/sup> ; § ; ; w.j.vandergiessen@erasmusmc.nl
- 关键词：coronary ; drug-eluting stent ; endothelial function ; endothelium derived hyperpolarizing factors ; microcirculation
- 刊名：JACC: Cardiovascular Interventions
- 出版年：2010
- 出版时间：July 2010
- 年：2010
- 卷：3
- 期：7
- 页码：723-730
- 全文大小：846 K
Objectives
The aim of this study was to compare the effects of single drug-eluting stents (DES) on porcine coronary function distal to the stent in vivo and in vitro.Background
The mechanism of endothelial dysfunction occurring in human coronary conduit arteries up to 9 months after DES implantation is unknown.
Methods
A sirolimus-eluting stent (SES), paclitaxel-eluting stent (PES), and a bare-metal stent (BMS) were implanted in the 3 coronary arteries of 11 pigs. After 5 weeks, in vivo responses in distal coronary flow to different doses of bradykinin (BK) and nitrates were measured. In vitro, vasodilation to BK and nitrates, as well as vasoconstriction to endothelin (ET)-1 were assessed in both distal coronary conduit and small arteries. In addition, contributions of nitric oxide (NO) and endothelium-derived hyperpolarizing factors (EDHFs) and cyclic guanosine monophosphate (cGMP) responses to BK-stimulation were determined in vitro.
Results
Both DES did not alter in vivo distal vasomotion. In vitro distal conduit and small arterial responses to BK were also unaltered; DES did not alter the BK-induced increase in cGMP. However, after NO synthase blockade, PES showed a reduced BK-response in distal small arteries as compared with BMS and SES (p < 0.05). The ET-1¨Cinduced vasoconstriction and vascular smooth muscle cell function were unaltered.
Conclusions
In this study of single stenting in healthy porcine coronaries for 5 weeks, SES did not affect distal coronary vascular function, whereas PES altered distal endothelial function of small arteries under conditions of reduced NO bioavailability. Therefore, specifically the EDH-component of microvascular function seems affected by PES.