Resistin ve Koroner Arter Ektazisi

Yıl 2016, Cilt: 19 Sayı: 3, 161 - 166, 01.12.2016

Muhammet Raşit Sayın , Mehmet Ali Çetiner İshak Özel Tekin Mustafa Aydın İbrahim Akpınar Turgut Karabağ Aydan Özbay Serpil Boz

Öz

Giriş:
Koroner arter ektazi (KAE)’den sorumlu olan
etyolojik ve patojenik etmenler belirgin değildir. Bizler KAE’si olan ve
olmayan olguları resistin düzeyleri açısından kıyaslamayı, böylelikle
resistinin KAE patogenezinde bir rolü olup olmadığını saptamayı amaçladık.

Hastalar
ve Yöntem: Çalışma 81 olgudan
oluşmaktaydı. Olguların 42’sinde (15’i kadın, ortalama yaş 60.4 ± 9.0 yıl), KAE
mevcut olup, 39 olguda (22’si kadın, ortalama yaş 56.2 ± 10.7 yıl) ise normal
koroner arter anatomisi vardı. Normal komşu segmentlere kıyasla en az 1.5 kat
koroner arter dilatasyonu mevcut olgular KAE olarak kabul edildiler. Koroner
anjiyografinin gerçekleştirildiği gün alınan kan örneklerinde resistin
düzeyleri ölçüldü.

Bulgular:
Her iki grubun referans özellikleri benzerdi. Serum
resistin düzeyi KAE grubunda [ortalama 703.5 ± 828.2 ng/L, ortanca 379.5
(40-492) ng/L] kontrol grubuna göre (ortalama 313.5 ± 252.6 ng/L, ortanca 256
(30-1244) ng/L] anlamlı şekilde daha yüksek saptandı (p= 0.001).

Sonuç:
KAE ve
aterosklerozis ortak histopatolojik ve klinik özellikler arz etmektedir.
Resistin, aterosklerozun gelişiminde ve klinik tablonun oluşumundaki yeri iyi
bilinen bir polipeptid olup, aynı zamanda KAE oluşumunda da rol alıyor
olabilir. Resistinin KAE’nin oluşumunda ki yerinin daha iyi anlaşılabilmesi
için büyük ölçekli çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Ektazi, resistin, adipokin

High Serum Resistin Levels in Coronary Artery Ectasia

Öz

Introduction:
The etiological and pathogenic factors responsible
for coronary artery ectasia (CAE) are unclear. Therefore, we aimed to compare
subjects with and without CAE with respect to resistin levels and determine
whether resistin plays a role in the aetiology or pathogenesis of CAE.

Patients
and Methods: This study enrolled a total of 81 subjects,
of whom 42 had CAE [15 female (F), mean age 60.4 ± 9.0 years] and 39 had a
normal coronary anatomy (22 F, mean age 56.2 ± 10.7 years). Using coronary
artery diameters of the control group as reference, subjects having coronary
artery dilatation that was at least 1.5 times larger than the normal adjacent
segments were considered to have CAE. Resistin levels were measured from blood
samples obtained on the day of the coronary angiography.

Results: Both
the groups had similar baseline characteristics. Serum resistin levels were
significantly higher in the CAE group [mean 703.5 ± 828.1 ng/L, median 379.5
(40-4092) ng/L] than in the control group [mean 313.5 ± 252.6 ng/L, median 256
(30-1244) ng/L] (p= 0.001).

Conclusion:
CAE and atherosclerosis share common
histopathological and clinical characteristics. Resistin, a polypeptide with a
known role in the development and clinical presentation of atherosclerosis, may
also mediate the formation of CAE. There is a need for future studies with a
larger sample size to better delineate the effect of resistin on the
development of CAE. 

Anahtar Kelimeler

Ectasia, resistin, adipokine

Kaynakça

• 1. Hartnell GG, Parnell BM, Pridie RB. Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients. Br Heart J 1985;54:392-5.
• 2. Mavrogeni S. Coronary artery ectasia: from diagnosis to treatment. Hellenic J Cardiol 2010;51:158-63.
• 3. Ozcan OU, Gulec S. Coronary artery ectasia. Cor et Vasa 2013;55: e242-e247.
• 4. Swanton RH, Thomas ML, Coltart DJ, Jenkins BS, Webb-Peploe MM, Williams BT. Coronary artery ectasia--a variant of occlusive coronary arteriosclerosis. Br Heart J 1978;40:393-400.
• 5. Collins MJ, Borges AJ, Singh G, Pillai JB, David TE, Leong SW, et al. A giant coronary artery aneurysm in the right coronary artery. Cardiovasc Pathol 2006;15:150-2.
• 6. Antoniadis AP, Chatzizisis YS, Giannoglou GD. Pathogenetic mechanisms of coronary ectasia. Int J Cardiol 2008;130:335-43.
• 7. Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, et al. The hormone resistin links obesity to diabetes. Nature 2001;409:307-12.
• 8. Janke J, Engeli S, Gorzelniak K, Luft FC, Sharma AM. Resistin gene expression in human adipocytes is not related to insulin resistance. Obes Res 2002;10:1-5.
• 9. Fain JN, Cheema PS, Bahouth SW, Lloyd Hiler M. Resistin release by human adipose tissue explants in primary culture. Biochem Biophys Res Commun 2003;300:674-8.
• 10. Jamaluddin MS, Weakley SM, Yao Q, Chen C. Resistin: functional roles and therapeutic considerations for cardiovascular disease. Br J Pharmacol 2012;165:622-32.
• 11. Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation 1983;67:134-8.
• 12. Tunick PA, Slater J, Kronzon I, Glassman E. Discrete atherosclerotic coronary artery aneurysms: a study of 20 patients. J Am Coll Cardiol 1990;15:279-82.
• 13. Boztosun B, Gunes Y, Kırma C. Koroner arter ektazisi-Coronary artery ectasia. Türk Kardiyol Dern Arş-Arch Turk Soc Cardiol 2005;33:356-9.
• 14. Syed M, Lesch M. Coronary artery aneurysm: a review. ProgCardiovasc Dis 1997;40:77-84.
• 15. Yetkin E, Waltenberger J. Novel insights into an old controversy: is coronary artery ectasia a variant of coronary atherosclerosis? Clin Res Cardiol 2007;96:331-9.
• 16. Manginas A, Cokkinos DV. Coronary artery ectasias: imaging, functional assessment and clinical implications. Eur Heart J 2006;27:1026-31.
• 17. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary arterial ectasia. Am J Cardiol 1976;37:217-22.
• 18. Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med 1987;316:1371-5.
• 19. Zarins CK, Weisenberg E, Kolettis G, Stankunavicius R, Glagov S. Differential enlargement of artery segments in response to enlarging atherosclerotic plaques. J Vasc Surg 1988;7:386-94.
• 20. Bentzon JF, Pasterkamp G, Falk E. Expansive remodeling is a response of the plaque-related vessel wall in aortic roots of apoE-deficient mice: an experiment of nature. Arterioscler Thromb Vasc Biol 2003;23:257-62.
• 21. Yilmaz H, Tayyareci G, Sayar N, Gurkan U, Tangurek B, Asilturk R, et al. Plasma soluble adhesion molecule levels in coronary artery ectasia. Cardiology 2006;105:176-81.
• 22. Turhan H, Erbay AR, Yasar AS, Aksoy Y, Bicer A, Yetkin G, et al. Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selectin levels in patients with isolated coronary artery ectasia. Coron Artery Dis 2005;16:45-50.
• 23. Turhan H, Erbay AR, Yasar AS, Balci M, Bicer A, Yetkin E. Comparison of C-reactive protein levels in patients with coronary artery ectasia versus patients with obstructive coronary artery disease. Am J Cardiol 2004;94:1303-6.
• 24. Savino M, Parisi Q, Biondi-Zoccai GG, Pristipino C, Cianflone D, Crea F. New insights into molecular mechanisms of diffuse coronary ectasiae: a possible role for VEGF. Int J Cardiol 2006;106:307-12.
• 25. Zhao L, Moos MP, Gräbner R, Pédrono F, Fan J, Kaiser B, et al. The 5-lipoxygenase pathway promotes pathogenesis of hyperlipidemia-dependent aortic aneurysm. Nat Med 2004;10:966-73.
• 26. Brunetti ND, Salvemini G, Cuculo A, Ruggiero A, De Gennaro L, Gaglione A, et al. Coronary artery ectasia is related to coronary slow flow and inflammatory activation. Atherosclerosis 2014;233:636-40.
• 27. Aydin M, Tekin IO, Dogan SM, Yildirim N, Arasli M, Sayin MR, et al. The levels of tumor necrosis factor-alpha and interleukin-6 in patients with isolated coronary artery ectasia. Mediators Inflamm 2009:106145. doi: 10.1155/2009/106145.
• 28. Dagli N, Ozturk U, Karaca I, Yavuzkir M, Koca S, Akbulut H, et al. Adiponectin levels in coronary artery ectasia. Heart Vessels 2009;24:84-9.
• 29. Reilly MP, Lehrke M, Wolfe ML, Rohatgi A, Lazar MA, Rader DJ. Resistin is an inflammatory marker of atherosclerosis in humans. Circulation 2005;111:932-9.
• 30. Ohmori R, Momiyama Y, Kato R, Taniguchi H, Ogura M, Ayaori M, et al. Associations between serum resistin levels and insulin resistance, inflammation, and coronary artery disease. J Am Coll Cardiol 2005;46:379-80.
• 31. Pischon T, Bamberger CM, Kratzsch J, Zyriax BC, Algenstaedt P, Boeing H, et al. Association of plasma resistin levels with coronary heart disease in women. Obes Res 2005;13:1764-71.
• 32. Weikert C, Westphal S, Berger K, Dierkes J, Möhlig M, Spranger J, et al. Plasma resistin levels and risk of myocardial infarction and ischemic stroke. J Clin Endocrinol Metab 2008;93:2647-53.
• 33. Lubos E, Messow CM, Schnabel R, Rupprecht HJ, Espinola-Klein C, Bickel C, et al. Resistin, acute coronary syndrome and prognosis results from the Athero Gene study. Atherosclerosis 2007;193:121-8.
• 34. Chu S, Ding W, Li K, Pang Y, Tang C. Plasma resistin associated with myocardium injury in patients with acute coronary syndrome. Circ J 2008;72:1249-53.
• 35. Wang H, Chen DY, Cao J, He ZY, Zhu BP, Long M. High serum resistin level may be an indicator of the severity of coronary disease in acute coronary syndrome. Chin Med Sci J 2009;24:161-6.
• 36. Kreçki R, Krzemińska-Pakuła M, Peruga JZ, Szcześniak P, Lipiec P, Wierzbowska-Drabik K, et al. Elevated resistin opposed to adiponectin or angiogenin plasma levels as a strong, independent predictive factor for the occurrence of major adverse cardiac and cerebrovascular events in patients with stable multivessel coronary artery disease over 1-year follow-up. Med Sci Monit 2011;17:CR26-32.
• 37. Momiyama Y, Ohmori R, Uto-Kondo H, Tanaka N, Kato R, Taniguchi H, et al. Serum resistin levels and cardiovascular events in patients undergoing percutaneous coronary intervention. J Atheroscler Thromb 2011;18:108-14.
• 38. Korah TE, Ibrahim HH, Badr EA, ElShafie MK. Serum resistin in acute myocardial infarction patients with and without diabetes mellitus. Postgrad Med J 2011;87:463-7.
• 39. Burnett MS, Lee CW, Kinnaird TD, Stabile E, Durrani S, Dullum MK, et al.The potential role of resistin in atherogenesis. Atherosclerosis 2005;182:241-8.
• 40. Xu W, Yu L, Zhou W, Luo M. Resistin increases lipid accumulation and CD36 expression in human macrophages. Biochem Biophys Res Commun 2006;351:376-82.
• 41. Lee TS, Lin CY, Tsai JY, Wu YL, Su KH, Lu KY, et al. Resistin increases lipid accumulation by affecting class A scavenger receptor, CD36 and ATP-binding cassette transporter-A1 in macrophages. Life Sci 2009;84:97-104.
• 42. Jung HS, Park KH, Cho YM, Chung SS, Cho HJ, Cho SY, et al. Resistin is secreted from macrophages in atheromas and promotes atherosclerosis. Cardiovasc Res 2006;69:76-85.
• 43. Cosmacini P, Veronesi P, Zurrida S, Sacchini V, Ferranti C, Galimberti V, et al. [Nonpalpable breast lesions. General considerations and a review of the literature in the light of the authors’ own experience with 344 cases located preoperatively]. [Article in Italian] Radiol Med 1992;83:383-9.
• 44. Chen C, Jiang J, Lü JM, Chai H, Wang X, Lin PH, et al. Resistin decreases expression of endothelial nitric oxide synthase through oxidative stress in human coronary artery endothelial cells. Am J Physiol Heart Circ Physiol 2010;299:H193-201.
• 45. Verma S, Li SH, Wang CH, Fedak PW, Li RK, Weisel RD, et al. Resistin promotes endothelial cell activation: further evidence of adipokine-endothelial interaction. Circulation 2003;108:736-40.
• 46. Ding Q, Chai H, Mahmood N, Tsao J, Mochly-Rosen D, Zhou W. Matrix metalloproteinases modulated by protein kinase Cε mediate resistin-induced migration of human coronary artery smooth muscle cells. J Vasc Surg 2011;53:1044-51.
• 47. Mu H, Ohashi R, Yan S, Chai H, Yang H, Lin P, et al. Adipokineresistin promotes in vitro angiogenesis of human endothelial cells. Cardiovasc Res 2006;70:146-57.
• 48. Calabrò P, Cirillo P, Limongelli G, Maddaloni V, Riegler L, Palmieri R, et al. Tissue factor is induced by resistin in human coronary artery endothelial cells by the NF-ĸB-dependent pathway. J Vasc Res 2011;48:59-66.
• 49. Liu R, He B, Gao F, Liu Q, Yi Q. Relationship between adipokines and coronary artery aneurysm in children with Kawasaki disease. Transl Res 2012;160:131-6.
• 50. al-Harthi SS, Nouh MS, Arafa M, al-Nozha M. Aneurysmal dilatation of the coronary arteries: diagnostic patterns and clinical significance. Int J Cardiol 1991;30:191-4.
• 51. Rab ST, Smith DW, Alimurung BN, Rab R, King SB 3rd. Thrombolytic therapy in coronary ectasia and acute myocardial infarction. Am Heart J 1990;119:955-7.
• 52. Papadakis MC, Manginas A, Cotileas P, Demopoulos V, Voudris V, Pavlides G, et al. Documentation of slow coronary flow by the TIMI frame count in patients with coronary ectasia. Am J Cardiol 2001;88:1030-2.
• 53. Canga A, Cetin M, Kocaman SA, Durakoğlugil ME, Kırbaş A, Erdoğan T, et al. Increased serum resistin levels in patients with coronary slow-flow phenomenon. Herz 2013;38:773-8.