Vol 11, No 5 (2007)
Original paper
Published online: 2007-10-03
The influence of contrast medium used during coronary angiography procedure on nitrite/nitrate and endothelin-1 levels in blood of patients with arterial hypertension
Nadciśnienie tętnicze 2007;11(5):406-411.
Abstract
Background Mechanisms underlying manifestation of
contrast-induced nephropathy (CIN) are still not clear.
Endothelial dysfunction present in patients with arterial
hypertension may probably be one of the factors. The aim
of the study was to determine the influence of contrast medium
used during coronary angiography on creatinine serum
level and two parameters connected with endothelial
function such as nitric oxide (NO) measured indirectly by
nitrite/nitrate concentration and endothelin-1 (ET-1) in patients
with arterial hypertension in whom some protective
strategies against contrast-induced nephropathy were used.
Material and methods Studies were carried out in 72 patients (58 men and 14 women, mean age: 57.4 ± 10.7 years) with arterial hypertension. In all patients coronary angiography with the use of non-ionic contrast medium was performed due to symptoms of coronary heart disease. Prophylactic therapy of intravenous hydration with 0.9% NaCl and acetylcysteine prior to and after coronary angiography was used. Serum creatinine level before and early after coronarography was measured. Endothelial function wasestimated by concentrations endothelin-1 and indirectly nitric oxide by measurement of nitrite/nitrate in blood before and then one and six hours after the invasive procedure.
Results Serum creatinine level as well as endothelin-1 in plasma did not change significantly after the examination. Serum nitric oxide concentration was significantly lower after coronary angiography after one and after six hours in comparison with measurements before the invasive procedure (p < 0.01).
Conclusions Performed studies show that the use of contrast media during coronary angiography may decrease level of nitrite/nitrate causing endothelial dysfunction. Preventive therapy with hydration and orally administered acetylcysteine before and after coronary angiography may be an effective protective strategy, even though the decrease in nitrite/nitrate level is detected.
Arterial Hypertension 2007, vol. 11, no 5, pages 406-411.
Material and methods Studies were carried out in 72 patients (58 men and 14 women, mean age: 57.4 ± 10.7 years) with arterial hypertension. In all patients coronary angiography with the use of non-ionic contrast medium was performed due to symptoms of coronary heart disease. Prophylactic therapy of intravenous hydration with 0.9% NaCl and acetylcysteine prior to and after coronary angiography was used. Serum creatinine level before and early after coronarography was measured. Endothelial function wasestimated by concentrations endothelin-1 and indirectly nitric oxide by measurement of nitrite/nitrate in blood before and then one and six hours after the invasive procedure.
Results Serum creatinine level as well as endothelin-1 in plasma did not change significantly after the examination. Serum nitric oxide concentration was significantly lower after coronary angiography after one and after six hours in comparison with measurements before the invasive procedure (p < 0.01).
Conclusions Performed studies show that the use of contrast media during coronary angiography may decrease level of nitrite/nitrate causing endothelial dysfunction. Preventive therapy with hydration and orally administered acetylcysteine before and after coronary angiography may be an effective protective strategy, even though the decrease in nitrite/nitrate level is detected.
Arterial Hypertension 2007, vol. 11, no 5, pages 406-411.
Keywords: contrast nephropathynitrite/nitrateendothelin-1arterial hypertensioniodine contrast media