Skip to main content
SpringerLink
Log in

Serum endocan levels in patients with cardiac syndrome X

Endocanspiegel im Serum bei Patienten mit kardialem Syndrom X

  • Original articles
  • Published:
Herz Aims and scope Submit manuscript

Abstract

Background

Endocan is a recently introduced marker of endothelial dysfunction and is also associated with inflammation and atherosclerosis. To date, the relationship between cardiac syndrome X (CSX) and endocan has not been studied. The objective of this study was to compare the serum endocan levels of patients with CSX with those of control subjects.

Patients and methods

In this study, 50 patients were included in the CSX group and 28 patients in the control group. Patients with pathological conditions that could potentially influence endothelial functions were excluded. Endocan serum concentrations were measured using an enzyme-linked immunosorbent assay.

Results

The mean endocan level of the CSX group was significantly higher than that of the control group (3051.3 ± 1900.5 ng/l vs. 2088.1 ± 522.2 ng/l; p = 0.002). There was no difference between the two groups in terms of age, gender, hypertension, diabetes mellitus, dyslipidemia, and smoking status. In receiver operating characteristic (ROC) curve analysis, endocan levels greater than 2072 ng/l had a 72% sensitivity and 54% specificity (p = 0.002) for accurately predicting a diagnosis of CSX.

Conclusion

The results of this study suggest that patients with CSX have higher endocan levels. Therefore, endocan may be valuable in helping uncover the underlying pathogenesis of CSX.

Zusammenfassung

Hintergrund

Endocan wurde vor Kurzem als Marker der endothelialen Dysfunktion eingeführt und ist auch mit entzündlichen Prozessen und Atherosklerose assoziiert. Ein Zusammenhang zwischen kardialem Syndrom X (KSX) und Endocan ist bis jetzt noch nicht festgestellt worden. Das Ziel der Studie war der Vergleich des Endocanspiegels im Serum zwischen KSX- und Kontrollpatienten.

Methodik

Zur KSX-Gruppe gehörten 50 Patienten und zur Kontrollgruppe 28 Patienten. Ausgeschlossen wurden Patienten mit anderen Erkrankungen, die zu potenzieller endothelialer Dysfunktion führen können. Der Endocanspiegel im Serum wurde mittels „enzyme-linked immunosorbent assay“ (ELISA) gemessen.

Ergebnisse

Der durchschnittliche Endocanspiegel der KSX-Gruppe war deutlich höher als der der Kontrollgruppe (3051,3 ± 1900,5 ng/l vs. 2088,1 ± 522,2 ng/l; p = 0,002). Es zeigte sich kein signifikanter Unterschied zwischen den Gruppen in Bezug auf Alter, Geschlecht, Hypertonie, Diabetes mellitus, Dyslipidämie und Rauchen. In der Receiver-Operating-Characteristic(ROC)-Analyse zeigte sich eine Sensitivität von 72 % und Spezifität von 54 % für Endocanspiegel über 2072 ng/l (p = 0,002) zur Vorhersage der KSX-Diagnose.

Schlussfolgerung

Die Ergebnisse der Studie weisen auf höhere Endocanspiegel bei KSX-Patienten hin. Dies kann wertvoll für das weitere Verständnis der zugrunde liegenden Pathogenese bei KSX-Patienten sein.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sullivan AK, Holdright DR, Wright CA, Sparrow JL, Cunningham D, Fox KM (1999) Chest pain in women: clinical, investigative, and prognostic features. BMJ 308:883–886

    Article  Google Scholar 

  2. Task Force Members, Montalescot G, Sechtem U et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003

    Article  Google Scholar 

  3. Bugiardini R, Bairey Merz CN (2005) Angina with “normal” coronary arteries: a changing philosophy. JAMA 293:477–484

    Article  PubMed  CAS  Google Scholar 

  4. Lassalle P, Molet S, Janin A, Heyden JV, Tavernier J, Fiers W et al (1996) ESM-1 is a novel human endothelial cell-specific molecule expressed in lung and regulated by cytokines. J Biol Chem 271:20458–20464

    Article  PubMed  CAS  Google Scholar 

  5. Del Toro R, Prahst C, Mathivet T, Siegfried G, Kaminker JS, Larrivee B et al (2010) Identification and functional analysis of endothelial tip cell-enriched genes. Blood 116(20705756):4025–4033

    Article  PubMed  PubMed Central  Google Scholar 

  6. Maurage CA, Adam E, Minéo JF, Sarrazin S, Debunne M, Siminski RM et al (2009) Endocan expression and localization in human glioblastomas. J Neuropathol Exp Neurol 68:633–641

    Article  PubMed  CAS  Google Scholar 

  7. Carrillo LM, Arciniegas E, Rojas H, Ramírez R (2011) Immunolocalization of endocan during the endothelial-mesenchymal transition process. Eur J Histochem 55:e13

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Recchia FM, Xu L, Penn JS, Boone B, Dexheimer PJ (2010) Identification of genes and pathways involved in retinal neovascularization by microarray analysis of two animal models of retinal angiogenesis. Invest Ophthalmol Vis Sci 51(19834031):1098–1105

    Article  PubMed  PubMed Central  Google Scholar 

  9. Delehedde M, Devenyns L, Maurage CA, Vives RR (2013) Endocan in cancers: a lesson from a circulating dermatan sulfate proteoglycan. Int J Cell Biol. doi:10.1155/2013/705027

    Article  PubMed  PubMed Central  Google Scholar 

  10. Balta I, Balta S, Demirkol S et al (2013) Elevated serum levels of endocan in patients with psoriasis vulgaris: correlations with cardiovascular risk and activity of disease. Br J Dermatol 169:1066–1070

    Article  PubMed  CAS  Google Scholar 

  11. Scherpereel A, Depontieu F, Grigoriu B et al (2006) Endocan, a new endothelial marker in human sepsis. Crit Care Med 34:532–537

    Article  PubMed  CAS  Google Scholar 

  12. Kim JH, Park MY, Kim CN et al (2012) Expression of endothelial cellspecific molecule-1 regulated by hypoxia inducible factor-1a in human colon carcinoma: impact of ESM-1 on prognosis and its correlation with clinicopathological features. Oncol Rep 28:1701–1708

    Article  PubMed  CAS  Google Scholar 

  13. Balta S, Mikhailidis DP, Demirkol S et al (2014) Endocan – a novel inflammatory indicator in newly diagnosed patients with hypertension: a pilot study. Angiology 65:773–777

    Article  PubMed  CAS  Google Scholar 

  14. Su YH, Shu KH, Hu CP et al (2014) Serum endocan correlated with stage of chronic kidney disease and deterioration in renal transplant recipients. Transplant Proc 46:323–327

    Article  PubMed  CAS  Google Scholar 

  15. Yilmaz MI, Siriopol D, Saglam M et al (2014) Plasma endocan levels associate with inflammation, vascular abnormalities, cardiovascular events, and survival in chronic kidney disease. Kidney Int 86(6):1213–1220. doi:10.1038/ki.2014.227

    Article  PubMed  CAS  Google Scholar 

  16. Balta S, Demirkol S, Ozturk C, Yildirim AO, Demir M, Celik T (2016) The relation between endocan levels and subclinic atherosclerosis. Clin Appl Thromb Hemost 22(5):495–496

    Article  PubMed  CAS  Google Scholar 

  17. Qiu CR, Fu Q, Sui J, Zhang Q, Wei P, Wu Y et al (2016) Serum endothelial cell-specific molecule 1 (endocan) levels in patients with acute myocardial infarction and its clinical significance: a pilot study. Angiology 68(4):354–359. doi:10.1177/0003319716651349

  18. Çimen T, Efe TH, Akyel A, Sunman H, Algül E, Şahan HF et al (2016) Human endothelial cell-specific molecule-1 (endocan) and coronary artery disease and microvascular angina. Angiology 67(9):846–853. doi:10.1177/0003319715625827

  19. Hackett D, Larkin S, Chierchia S, Davies G, Kaski JC, Maseri A (1987) Induction of coronary artery spasm by a direct local action of ergonovine. Circulation 75:577–582

    Article  PubMed  CAS  Google Scholar 

  20. Ong P, Athanasiadis A, Borgulya G, Mahrholdt H, Kaski JC, Sechtem U (2012) High prevalence of a pathological response to acetylcholine testing in patients with stable angina pectoris and unobstructedcoronary arteries: the ACOVA Study (Abnormal COronary VAsomotion in patients with stable anginaand unobstructed coronary arteries). J Am Coll Cardiol 59:655–662

    Article  PubMed  CAS  Google Scholar 

  21. Hurst T, Olson T, Olson L et al (2006) Cardiac syndrome X and endothelialdysfunction: new concepts in prognosis and treatment. Am J Med 119:560–566

    Article  PubMed  Google Scholar 

  22. Demirkol S, Balta S, Unlu M et al (2014) Neutrophils/lymphocytes ratioin patients with cardiac syndrome X and its association withcarotid intima-media thickness. Clin Appl Thromb Hemost 20:250–255

    Article  PubMed  Google Scholar 

  23. Lanza GA, Crea F (2010) Primary coronary microvascular dysfunction: clinical presentation, pathophysiology, and management. Circulation 121:2317–2325

    Article  PubMed  Google Scholar 

  24. Kirkpatrick CJ, Wagner M, Hermanns I, Klein CL, Kohler H, Otto M et al (2015) Physiology and cell biology of the endothelium: a dynamic interface for cell communication. Int J Microcirc Clin Exp 17:231–240

    Article  Google Scholar 

  25. Panes J, Perry M, Granger DN (1999) Leukocyte-endothelial cell adhesion: avenues for therapeutic intervention. Br J Pharmacol 126:537–550

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Lee W, Ku SK, Kim SW, Bae JS (2014) Endocan elicits severe vascular inflammatory responses in vitro and in vivo. J Cell Physiol 229:620–630

    Article  PubMed  CAS  Google Scholar 

  27. Jaipersad AS, Lip GY, Silverman S, Shantsila E (2014) The role of monocytes in angiogenesis and atherosclerosis. J Am Coll Cardiol 63:1–11

    Article  PubMed  CAS  Google Scholar 

  28. Ye MF, Zhao ZW, Luo YK, Dong XF, Yan YM (2016) Elevated endocan concentration is associated with coronary slow flow. Scand J Clin Lab Invest 16:1–4

    Google Scholar 

  29. Kundi H, Balun A, Cicekcioglu H, Karayigit O, Topcuoglu C, Kilinckaya MF et al (2017) Admission endocan level may be a useful predictor for in-hospital mortality and coronary severity index in patients with ST-segment elevation myocardial infarction. Angiology 68:46

    Article  PubMed  CAS  Google Scholar 

  30. Turan T, Akyuz AR, Aykan AC, Kul S, Cirakoglu OF, Aslan AO et al (2016) Plasma endocan levels in patients with isolated coronary artery ectasia. Angiology 67:932. doi:10.1177/0003319716637789

    Article  PubMed  CAS  Google Scholar 

  31. Xiong C, Zhao ZW, Chen ZY, Wu LZ, Luo YK, Hu FD et al (2015) Elevated human endothelial cell-specific molecule-1 level and its association with coronary artery disease in patients with hypertension. J Investig Med 63(7):867–870. doi:10.1097/JIM.0000000000000219

    Article  PubMed  CAS  Google Scholar 

  32. Lind L (2003) Circulating markers of inflammation and atherosclerosis. Atherosclerosis 169:203–214

    Article  PubMed  CAS  Google Scholar 

  33. Lanza GA, Sestito A, Cammarota G et al (2004) Assessment of systemicinflammation and infective pathogen burden in patients withcardiac syndrome X. Am J Cardiol 94:40–44

    Article  PubMed  Google Scholar 

  34. Büyükkaya E, Karakaş MF, Kurt M, Motor S, Akçay AB, Büyükkaya S et al (2013) The serum pentraxin-3 is elevated in patients with cardiac syndrome X. Turk Kardiyol Dern Ars 41(4):290–295

    Article  PubMed  Google Scholar 

  35. Bozcali E, Polat V, Aciksari G, Opan S, Bayrak IH, Paker N et al (2014) Serum concentrations of galectin-3 in patients with cardiac syndrome X. Atherosclerosis 237(1):259–263

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Agrı State Hospital, Fırat mahallesi, 00004, Agrı, Turkey

    S. C. Efe MD

  2. Department of Cardiology, Goztepe Research and Education Hospital, Istanbul, Turkey

    K. Demirci MD

  3. Department of Cardiology, Haseki Training and Education Hospital, Istanbul, Turkey

    S. Ozturk MD

  4. Department of Cardiology, Eskisehir State Hospital, Eskisehir, Turkey

    A. S. Gurbuz MD

  5. Department of Cardiology, Herz-Zentrum Bodensee Konstanz, Konstanz, Germany

    N. Poci MD

  6. Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey

    A. Kilicgedik MD, A. Guler MD, M. F. Yilmaz MD, İ. A. İzgi MD & C. Kirma MD

Authors
  1. S. C. Efe MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Demirci MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Ozturk MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. S. Gurbuz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N. Poci MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Kilicgedik MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Guler MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. F. Yilmaz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. İ. A. İzgi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. C. Kirma MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. C. Efe MD.

Ethics declarations

Conflict of interest

S.C. Efe, K. Demirci, S. Ozturk, A.S. Gurbuz, N. Poci, A. Kılıcgedik, A. Guler, M.F. Yılmaz, İ.A. İzgi, and C. Kirma declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Author contributions: All of the authors contributed to the planning, conducting, and reporting of this study. All contributors are responsible for the overall content.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Efe, S.C., Demirci, K., Ozturk, S. et al. Serum endocan levels in patients with cardiac syndrome X. Herz 43, 359–363 (2018). https://doi.org/10.1007/s00059-017-4580-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00059-017-4580-3

Keywords

Schlüsselwörter

Search

Navigation