Abstract
Patients who experience chest pain, in which ischemic heart disease has been ruled out, still have an increased risk of future ischemic cardiac events and premature death, possibly due to subclinical endothelial dysfunction. A feature of endothelial dysfunction is an increased expression of arterial vasoconstrictor endothelin (ET) and angiotensin (AT) receptors. Our aim was to investigate if the arterial expressions of these receptors are changed in patients with suspected but ruled out acute coronary syndrome (ACS). Small subcutaneous arteries (diameter of 100 µm) were surgically removed in an abdominal biopsy from 12 patients suspicious of ACS (susp ACS), admitted to the medical telemetry unit for chest pain. The vessels were analyzed for their receptor protein expression by quantitative immunohistochemistry using specific antibodies directed against ETA, ETB, AT1, and AT2 receptors. The control group (controls) consisted of eight healthy volunteers matched for age and sex with no previous cardiac illness or medication. The susp ACS group had an increased expression of ETB (by 94%) and AT1 (by 34%) receptors in the smooth muscle cells of resistance arteries as compared to the control group. There were no significant differences in AT2 and ETA receptor expression between the groups. The results indicate that the expression of arterial smooth muscle ETB and AT1 receptors are increased in patients with suspected but ruled out ACS. These receptor changes could be important in the regulation of coronary tone and in the development of atherosclerosis, and may be related to increased cardiovascular risk.
Similar content being viewed by others
References
McMahon GC, Yates DW, Hollis S (2008) Unexpected mortality in patients discharged from the emergency department following an episode of nontraumatic chest pain. Eur J Emerg Med 15:3–8
Selwyn AP, Kinlay S, Libby P, Ganz P (1997) Atherogenic lipids, vascular dysfunction, and clinical signs of ischemic heart disease. Circulation 95:5–7
Verma S, Anderson TJ (2002) Fundamentals of endothelial function for the clinical cardiologist. Circulation 105:546–549
Szmitko PE, Wang CH, Weisel RD, de Almeida JR, Anderson TJ, Verma S (2003) New markers of inflammation and endothelial cell activation: Part I. Circulation 108:1917–1923
Stenman E, Edvinsson L (2004) Cerebral ischemia enhances vascular angiotensin AT1 receptor-mediated contraction in rats. Stroke 35:970–974
Lind H, Adner M, Erlinge D, Brunkwall J, Edvinsson L (1999) Selective increase of the contractile response to endothelin-1 in subcutaneous arteries from patients with essential hypertension. Blood Press 8:9–15
Sullivan ME, Dashwood MR, Thompson CS, Muddle JR, Mikhailidis DP, Morgan RJ (1997) Alterations in endothelin B receptor sites in cavernosal tissue of diabetic rabbits: potential relevance to the pathogenesis of erectile dysfunction. J Urol 158:1966–1972
Ekelund U, Nilsson HJ, Frigyesi A, Torffvit O (2002) Patients with suspected acute coronary syndrome in a university hospital emergency department: an observational study. BMC Emerg Med 2:1
Tschudi MR, Luscher TF (1994) Characterization of contractile endothelin and angiotensin receptors in human resistance arteries: evidence for two endothelin and one angiotensin receptor. Biochem Biophys Res Commun 204:685–690
Haynes WG, Strachan FE, Webb DJ (1995) Endothelin ETA and ETB receptors cause vasoconstriction of human resistance and capacitance vessels in vivo. Circulation 92:357–363
Ekelund U, Albert U, Edvinsson L, Mellander S (1993) In-vivo effects of endothelin-1 and ETA receptor blockade on arterial, venous and capillary functions in skeletal muscle. Acta Physiol Scand 148:273–283
Seo B, Oemar BS, Siebenmann R, von Segesser L, Luscher TF (1994) Both ETA and ETB receptors mediate contraction to endothelin-1 in human blood vessels. Circulation 89:1203–1208
White DG, Garratt H, Mundin JW, Sumner MJ, Vallance PJ, Watts IS (1994) Human saphenous vein contains both endothelin ETA and ETB contractile receptors. Eur J Pharmacol 257:307–310
Dagassan PH, Breu V, Clozel M, Kunzli A, Vogt P, Turina M, Kiowski W, Clozel JP (1996) Up-regulation of endothelin-B receptors in atherosclerotic human coronary arteries. J Cardiovasc Pharmacol 27:147–153
Hasdai D, Mathew V, Schwartz RS, Smith LA, Holmes DR, Jr., Katusic ZS, Lerman A (1997) Enhanced endothelin-B-receptormediated vasoconstriction of small porcine coronary arteries in diet-induced hypercholesterolemia. Arterioscler Thromb Vasc Biol 17:2737–2743
Haynes WG, Ferro CJ, O’Kane KP, Somerville D, Lomax CC, Webb DJ (1996) Systemic endothelin receptor blockade decreases peripheral vascular resistance and blood pressure in humans. Circulation 93:1860–1870
Batra VK, McNeill JR, Xu Y, Wilson TW, Gopalakrishnan V (1993) ETB receptors on aortic smooth muscle cells of spontaneously hypertensive rats. Am J Physiol 264:C479–C484
Barber DA, Michener SR, Ziesmer SC, Miller VM (1996) Chronic increases in blood flow upregulate endothelin-B receptors in arterial smooth muscle. Am J Physiol 270:H65–H71
Wackenfors A, Emilson M, Ingemansson R, Edvinsson L, Malmsjo M (2004) Ischemic heart disease down-regulates angiotensin type 1 receptor mRNA in human coronary arteries. Eur J Pharmacol 503:147–153
Hayzer DJ, Cicila G, Cockerham C, Griendling KK, Delafontaine P, Ng SC, Runge MS (1994) Endothelin A and B receptors are down-regulated in the hearts of hypertensive rats. Am J Med Sci 307:222–227
Zhang M, Ma H, Wang BS, Zhao YZ (2006) Angiotensin II type 2 receptor gene polymorphisms and cardioprotective role in essential hypertension. Heart Vessels 21:95–101
Sasamura H, Nakazato Y, Hayashida T, Kitamura Y, Hayashi M, Saruta T (1997) Regulation of vascular type 1 angiotensin receptors by cytokines. Hypertension 30:35–41
Wang CH, Li SH, Weisel RD, Fedak PW, Dumont AS, Szmitko P, Li RK, Mickle DA, Verma S (2003) C-reactive protein upregulates angiotensin type 1 receptors in vascular smooth muscle. Circulation 107:1783–1790
Savoia C, Touyz RM, Volpe M, Schiffrin EL (2007) Angiotensin type 2 receptor in resistance arteries of type 2 diabetic hypertensive patients. Hypertension 49:341–346
Tsutsumi Y, Matsubara H, Ohkubo N, Mori Y, Nozawa Y, Murasawa S, Kijima K, Maruyama K, Masaki H, Moriguchi Y, Shibasaki Y, Kamihata H, Inada M, Iwasaka T (1998) Angiotensin II type 2 receptor is upregulated in human heart with interstitial fibrosis, and cardiac fibroblasts are the major cell type for its expression. Circ Res 83:1035–1046
Chassagne C, Eddahibi S, Adamy C, Rideau D, Marotte F, Dubois-Rande JL, Adnot S, Samuel JL, Teiger E (2000) Modulation of angiotensin II receptor expression during development and regression of hypoxic pulmonary hypertension. Am J Respir Cell Mol Biol 22:323–332
Yang BC, Phillips MI, Mohuczy D, Meng H, Shen L, Mehta P, Mehta JL (1998) Increased angiotensin II type 1 receptor expression in hypercholesterolemic atherosclerosis in rabbits. Arterioscler Thromb Vasc Biol 18:1433–1439
Arun KH, Kaul CL, Ramarao P (2004) High glucose concentration augments angiotensin II mediated contraction via AT1 receptors in rat thoracic aorta. Pharmacol Res 50:561–568
Maharsy WM, Kadi LN, Issa NG, Bitar KM, Der-Boghossian AH, Abrahamian R, Bikhazi AB (2007) Cross-talk related to insulin and angiotensin II binding on myocardial remodelling in diabetic rat hearts. J Renin Angiotensin Aldosterone Syst 8:59–65
Ikeda N, Nakajima R, Tsunoda T, Nakamura M, Sugi K (2007) Insulin resistance and acute coronary syndrome in the young Japanese population have a strong association. Heart Vessels 22:165–169
Griendling KK, FitzGerald GA (2003) Oxidative stress and cardiovascular injury: Part I: basic mechanisms and in vivo monitoring of ROS. Circulation 108:1912–1916
Nickenig G, Harrison DG (2002) The AT(1)-type angiotensin receptor in oxidative stress and atherogenesis: part I: oxidative stress and atherogenesis. Circulation 105:393–396
Griendling KK, Minieri CA, Ollerenshaw JD, Alexander RW (1994) Angiotensin II stimulates NADH and NADPH oxidase activity in cultured vascular smooth muscle cells. Circ Res 74:1141–1148
Mancini GB, Henry GC, Macaya C, O’Neill BJ, Pucillo AL, Carere RG, Wargovich TJ, Mudra H, Luscher TF, Klibaner MI, Haber HE, Uprichard AC, Pepine CJ, Pitt B (1996) Angiotensin-converting enzyme inhibition with quinapril improves endothelial vasomotor dysfunction in patients with coronary artery disease. The TREND (Trial on Reversing ENdothelial Dysfunction) Study. Circulation 94:258–265
Prasad A, Tupas-Habib T, Schenke WH, Mincemoyer R, Panza JA, Waclawin MA, Ellahham S, Quyyumi AA (2000) Acute and chronic angiotensin-1 receptor antagonism reverses endothelial dysfunction in atherosclerosis. Circulation 101:2349–2354
Suwaidi JA, Hamasaki S, Higano ST, Nishimura RA, Holmes DR Jr, Lerman A (2000) Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation 101:948–954
Wilhelmsen L, Rosengren A, Hagman M, Lappas G (1998) “Nonspecific” chest pain associated with high long-term mortality: results from the primary prevention study in Goteborg, Sweden. Clin Cardiol 21:477–482
Meier P, Maillard M, Burnier M (2005) The future of angiotensin II inhibition in cardiovascular medicine. Curr Drug Targets Cardiovasc Haematol Disord 5:15–30
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dimitrijevic, I., Ekelund, U., Edvinsson, ML. et al. Increased expression of endothelin ETB and angiotensin AT1 receptors in peripheral resistance arteries of patients with suspected acute coronary syndrome. Heart Vessels 24, 393–398 (2009). https://doi.org/10.1007/s00380-008-1136-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00380-008-1136-8