Dynamic Exercise Induces Elevation of Plasma Levels of Endothelin-1 in Patients with Coronary Artery Disease

Abstract

In this investigation the response of endothelin-1 plasma levels to dynamic exercise in patients with coronary artery disease (CAD) was studied. The study population consisted of 20 patients with CAD, 16 men and 4 women (mean age 53 ±8.6 years). Seven normal volunteers all men (mean age 53.4 ±4.4 years) were studied as a control group. Seven patients had prior myocardial infarction. All patients and controls exercised on a multi stage bicycle ergometer; plasma endothelin-1 levels and hemodynamic indices were measured at rest, at peak exercise, and at two and six minutes after exercise. Of the 20 patients examined, 7 (35%) showed electrocardiographic (ECG) signs of myocardial ischemia during the stress test. The mean plasma endothelin-1 concentration increased significantly from 7.8 ±3.0 to 13.6 ±3.5 pg/mL at exercise peak (P < 0.05) only in patients who did not show ECG signs of myocardial ischemia and returned to baseline values during recovery (six minutes) (9.4 ±2.1 pg/mL). In normal subjects baseline endothelin-1 levels (9.4 ±4.2 pg/mL) were not significantly altered at peak exercise (10.8 ±4.7 pg/mL) and at recovery (11.3 ±3.6 pg/mL). The hemodynamic parameters were not correlated with the plasma endothelin-1 levels before, during, and after exercise in all groups. The present study demonstrated that the plasma levels of endothelin-1 in patients with CAD increased significantly during stress testing.