Ignite Creation Date:
2024-05-05 @ 11:58 AM
Last Modification Date:
2024-10-26 @ 9:17 AM
Study NCT ID:
NCT00190086
Status:
TERMINATED
Last Update Posted:
2005-09-19
First Post:
2005-09-11
Brief Title:
Syndrome X and Endothelial Dysfunction
Sponsor:
Far Eastern Memorial Hospital
Organization:
Far Eastern Memorial Hospital
Study Overview
Official Title:
None
Status:
TERMINATED
Status Verified Date:
2001-12
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Cardiac syndrome X is characterized by angina positve stress test and patent coronary angiography and its probable mechanism is microvascular dysfunction associated with endothelial dysfunction We used brachial artery flow-mediated vasodilation to assess the endothelial function of the patients with syndrome X coronary artery disease and controls Methods We enrolled 28 patients with syndrome X 11 healthy volunteers and 11 coronary artery disease patients All subjects underwent a 2-step brachial artery flow-related vasodilation test ultrasound artery diameter was measured at rest and after occlusion to assess endothelium-dependent vasodilation and after sublingual nitroglycerin to determine endothelium-independent condition Serum endothelin-1 assay was performed for all participants Results The cardiac syndrome X patients had lower brachial artery dilation ratio diameter after test diameter before test than controls 110 - 009 versus 127 - 011 p0013 but the ratio is still higher than CAD patients 110 - 009 versus 102 - 007 p0001 After sublingual nitroglycerin all 50 subjects had adequate vasodilation Besides normal controls have higher endothelin-1 level than the others
We concluded that syndrome X patients have worse endothelial function than healthy control but patients of CAD had even worse endothelium function than cardiac syndrome X patients
Keywords Cardiac syndrome X coronary artery disease endothelium-dependent vasodilation endothelium-independent vasodilation flow-mediated vasodilation endothelin-1
We concluded that syndrome X patients have worse endothelial function than healthy control but patients of CAD had even worse endothelium function than cardiac syndrome X patients
Keywords Cardiac syndrome X coronary artery disease endothelium-dependent vasodilation endothelium-independent vasodilation flow-mediated vasodilation endothelin-1
Detailed Description:
Cardiac syndrome x CSX which is defined as the combination of typical chest pain electrocardiography or nuclear medicine evidence suggesting myocardial ischemia and patent coronary arteriogram comprises approximately 10-30 of the patients undergoing coronary angiogram12 However since it was first introduced in 1973 the pathogenesis of CSX has remained an enigma1 2 Among all the hypothetic explanations of CSX including abnormal pain perception and non-cardiogenic origin of pain the coronary microvascular dysfunction microvascular angina which represents reduced microvascular dilatory response and increased resistence has been consistently found in CSX patients 2 3 This microvascular angina is believed to bridge the gap between the ischemic evidence and the normal-looking of coronary tree of CSX and seems attributed to the endothelium dysfunction ED another frequently reported abnormality in CSX23 By definition ED is characterized by the endothelium-dependent vasodilation EDVD impairment which is believed to be caused by decreased release of NO activity andor activity while the endotheliumindependent vasodilation EIVD remains preserved 234 Therefore it is asserted that endothelium-dependent dilatation of the resistance coronary arteries is defective in patients with CSX and such defects may contribute to the altered regulation of myocardial perfusion in these patients5 On the other hand ED play a pivotal role in the development progression and clinical manifestations of atherosclerosis as well as in the development of ischemia and thrombosis in the late stages of the disease by promoting coronary vasoconstriction and thrombosis4 Instead of using invasively intravascular measuring method used for endothelial function assessment Celermajer et al first introduced the non-invasive measurement of the flow-mediated vasodilation FMD of forearm brachial artery in the assessment of EDVD and EIVD6 This method was reported to have good correlation to the invasively intravascular studies in coronary systems4 In this study we want to compare the difference of forearm FMD which respond to specially programmed stimuli in three patient groups CSX coronary artery disease CAD and normal volunteers A two-staged stimulation strategy is utilized to assess the EDVD with cuff occlusion and EIVD with sublingual nitroglycerin consecutively A baseline plasma endothelin-1 ET-1 concentration is also checked for each patient enrolled
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None