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Titolo:
Endothelial and metabolic characteristics of patients with angina and angiographically normal coronary arteries - Comparison with subjects with insulin resistance syndrome and normal controls
Autore:
Piatti, P; Fragasso, G; Monti, LD; Caumo, A; Phan, CV; Valsecchi, G; Costa, S; Fochesato, E; Pozza, G; Pontiroli, AE; Chierchia, S;
Indirizzi:
IRCCS H San Rafaele, Div Cardiol, I-20132 Milan, Italy IRCCS H San Rafaele Milan Italy I-20132 iv Cardiol, I-20132 Milan, Italy Unita Malattie Metab, Cattedra Med Interna, Div Med, Milan, Italy Unita Malattie Metab Milan Italy dra Med Interna, Div Med, Milan, Italy Univ Vita Salute, Cattedra Clin Med Gen & Terapia Med, Milan, Italy Univ Vita Salute Milan Italy a Clin Med Gen & Terapia Med, Milan, Italy Div Stat & Epidemiol, Milan, Italy Div Stat & Epidemiol Milan ItalyDiv Stat & Epidemiol, Milan, Italy
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 5, volume: 34, anno: 1999,
pagine: 1452 - 1460
SICI:
0735-1097(19991101)34:5<1452:EAMCOP>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
SKELETAL-MUSCLE; SYNDROME-X; MICROVASCULAR ANGINA; GLUCOSE-TOLERANCE; INTRAVENOUS GLUCOSE; PLASMA ENDOTHELIN; NITRIC-OXIDE; BLOOD-FLOW; FOREARM; VASODILATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Piatti, P IRCCS H San Rafaele, Div Cardiol, Via Olgettina 60, I-20132 Milan, Italy IRCCS H San Rafaele Via Olgettina 60 Milan Italy I-20132 Italy
Citazione:
P. Piatti et al., "Endothelial and metabolic characteristics of patients with angina and angiographically normal coronary arteries - Comparison with subjects with insulin resistance syndrome and normal controls", J AM COL C, 34(5), 1999, pp. 1452-1460

Abstract

OBJECTIVES: This study was performed to characterize the endothelial and metabolic alterations of patients With angina and angiographically normal coronary arteries ("cardiac" syndrome X [CSX]) compared with subjects with insulin resistance syndrome ("metabolic" syndrome X [MSX]) and normal controls. BACKGROUND: Previous studies have found high. endothelin-1 levels, impaired endothelium-dependent vasodilation and insulin resistance in patients with angina pectoris and angiographically normal coronary arteries. On the other hand, subjects with insulin resistance syndrome have shown high endothelin-1 levels. METHODS: Thirty-five subjects were studied: 13 patients with angina pectoris and angiographically normal coronary arteries (CSX group); 9 subjects with insulin resistance syndrome (MSX group) and 13 normal controls. All subjects received an acute intravenous bolus of insulin (0.1 U/kg) combined with a euglycemic clamp and forearm indirect calorimetry. Endothelin-1 levels,nitrite/nitrate (NOx) levels, end products of nitric oxide metabolism, glucose infusion rates (index of insulin sensitivity) and their incremental areas (Delta AUCs [area under curves]) were measured during this period. RESULTS: Basal endothelin-1 levels were higher in CSX and MSX groups than in normal controls (8.19 +/- 0.46 and 6.97 +/- 0.88 vs. 3.67 +/- 0.99 pg/ml; p < 0.01), while basal NOx levels were significantly higher in MSX group than in CSX and normal controls (36.5 +/- 4.0 vs. 24.2 +/- 3.3 and 26.8 +/-3.2 mol/liter, p < 0.05). After insulin administration, the Delta AUCs of NOx (p < 0.05) were lower in CSX group than in MSX and normal controls, andthe Delta AUCs of endothelin-1 were lower in group CSX than in normal controls. Glucose infusion rate was significantly lower in CSX and MSX groups than in normal controls (p < 0.01), suggesting that in both CSX and MSX groups insulin resistance is present. A positive correlation was found between the Delta AUCs of nitric oxide and the AUCs of glucose infusion rate. CONCLUSIONS: Blunted nitric oxide and endothelin responsiveness to intravenously infused insulin is a typical feature of patients with angina pectoris and angiographically normal coronary arteries and may contribute to the microvascular dysfunction observed in these subjects. (C) 1999 by the American College of Cardiology.

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Documento generato il 18/09/20 alle ore 10:58:52