Dyslipidemia and endothelium-dependent relaxation in internal mammary arteries used for coronary bypass surgery

doi:10.1016/S0008-6363(97)00081-3

Cardiovascular Research 1997 34(3):568-574; doi:10.1016/S0008-6363(97)00081-3
© 1997 by European Society of Cardiology

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Dyslipidemia and endothelium-dependent relaxation in internal mammary arteries used for coronary bypass surgery

Adriaan A. Voors^a^,b^,c^,*, Margreeth Oosterga^a^,c, Hendrik Buikema^a, Johan F. May^c, Jan G. Grandjean^d, Azuwerus van Buiten^a and Wiek H. van Gilst^a

^aDepartment of Clinical Pharmacology, University of Groningen, A. Deusinglaan 1, 9713AV, Groningen, Netherlands
^bR&D Cardiology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, Netherlands
^cDepartment of Cardiology, University Hospital Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, Netherlands
^dDepartment of Cardiothoracic Surgery, University Hospital Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, Netherlands

^* Corresponding author. Tel.: +31 (50) 3632810; fax: +31 (50) 3632812; e-mail: a.a.voors@med.rug.nl

Objective:Impairment of endothelium-dependent relaxation isrelated to dyslipidemia and may be an early marker for atherosclerosisin angiographically smooth arteries. The aim of the presentstudy was to relate preoperative serum lipids to endothelium-dependentrelaxation in internal mammary arteries of patients undergoingcoronary bypass surgery. Methods: The study group consistedof 37 patients, from whom segments of the internal mammary arterywere obtained during surgery. Measurements of endothelium-dependentrelaxation were performed in organ baths by adding methacholine(10 nM–10 µM). Results: All internal mammary arteriesdilated in response to methacholine, ranging from 4 to 112%of the precontraction to 10 µmol phenylephrine. In a multipleregression model, increased total serum cholesterol appearedto be the best predictor for impaired endothelium-dependentrelaxation. A 1 mmol increase of total cholesterol was associatedwith a 11.2% decrease of endothelium-dependent relaxation (P=0.006).When total cholesterol was omitted from the model, LDL-cholesterolbecame the best predictor of endothelium-dependent relaxation(regression coefficient 10.3%/mmol; P=0.02). No other variablewas significantly associated with endothelium-dependent relaxation,and none of the preoperative variables was associated with endothelium-independentrelaxation, expressed as the response to sodium nitrite (10mM). Conclusion: Our study showed that endothelium-dependentrelaxation in apparently non-diseased internal mammary arteriesused for coronary bypass surgery was independently related topreoperative (LDL)-cholesterol levels.

KEYWORDS Endothelial function; Coronary artery bypass; Cholesterol; LDL-cholesterol; Human, arteries

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