Transcardiac serotonin concentration is increased in selected patients with limiting angina and complex coronary lesion morphology.
Transcardiac serotonin concentration is increased in selected patients with limiting angina and complex coronary lesion morphology.
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DOI：
10.1161/01.cir.79.1.116
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发表时间：
1989
期刊：
影响因子：
37.8
通讯作者：
K. Egerton;van;Den Berg;James M. Schmitz;Claude R. Benedict;Craig R. Malloy;James T. Willerson;G. J. Dehmer
中科院分区：
文献类型：
--
作者：
K. Egerton;van;Den Berg;James M. Schmitz;Claude R. Benedict;Craig R. Malloy;James T. Willerson;G. J. Dehmer
血清素由活化的血小板释放，可能作为一种介质在人类中引发或维持某些不稳定的缺血性心脏病综合征。为了确定在患有严重、限制性心绞痛的患者中冠状动脉床两端的血清素浓度是否升高，我们通过一种灵敏的放射性酶测定法测量了39例冠状动脉疾病患者和13例冠状动脉造影显示仅有轻微或无冠状动脉病变患者的主动脉中部和冠状窦血清素浓度。尽管这两组之间的平均主动脉或冠状窦血清素浓度没有差异，但在23%的冠状动脉疾病患者中检测到冠状窦血清素浓度升高。有明显冠状动脉疾病的患者冠状窦和主动脉血清素浓度差值（0.6 ± 6.62纳克/毫升）比无明显冠状动脉疾病的患者（-5.6 ± 10.32纳克/毫升）（均值±标准差）更大（p < 0.05）。进一步分析显示，有偏心、不规则冠状动脉病变或管腔内充盈缺损的患者冠状窦和主动脉血清素差值（3.1 ± 5.54纳克/毫升）与有光滑同心病变的患者（-1.9 ± 6.61纳克/毫升）相比显著升高（p < 0.02）。这些数据表明，血清素在一些冠状动脉疾病患者的冠状循环中释放，特别是那些频繁发作心绞痛和有复杂冠状动脉病变的患者。尽管血清素可能在一些冠状动脉疾病患者中释放，但血清素在人类某些冠状动脉综合征的发生或持续过程中的具体病理生理作用仍有待确定。
Serotonin is released by activated platelets and may act as a mediator to initiate or sustain certain unstable syndromes of ischemic heart disease in humans. To determine whether or not serotonin concentration increases across the coronary bed in patients with severe, limiting angina, we measured central aortic and coronary sinus serotonin concentrations by a sensitive radioenzymatic assay in 39 patients with coronary artery disease and 13 patients with minimal or no coronary artery lesions as detected by arteriography. Although no difference existed in the mean aortic or coronary sinus serotonin concentrations between these two groups, elevated coronary sinus serotonin concentrations were detected in 23% of those with coronary artery disease. The coronary sinus and aortic serotonin concentration difference was greater in patients with significant coronary artery disease (0.6 +/- 6.62 ng/ml) compared with patients without significant coronary artery disease (-5.6 +/- 10.32 ng/ml) (mean +/- SD) (p less than 0.05). Further analysis revealed that patients with eccentric, irregular coronary artery lesions or intraluminal filling defects had a significantly elevated coronary sinus and aortic serotonin difference (3.1 +/- 5.54 ng/ml) compared with those with smooth concentric lesions (-1.9 +/- 6.61 ng/ml) (p less than 0.02). These data suggest that serotonin is released into the coronary circulation of some patients with coronary artery disease, especially those with frequent angina and complex coronary lesions. Although serotonin may be released in some patients with coronary artery disease, the specific pathophysiologic role of serotonin in the development or perpetuation of certain coronary syndromes in humans remains to be determined.