Endothelial Regulation of Vascular Tone and Growth

The endothelium regulates vascular tone by releasing factors involved in relaxation and contraction, in coagulation and thrombus formation, and in growth inhibition and stimulation. Endothelium-dependent relaxations are elicited by transmitters, hormones, platelet substances, and the coagulation system, and by physical stimuli such as the shear stress from circulating blood. They are mediated by the endothelium-derived relaxing factor, recently identified as nitric oxide, which causes vasodilation and platelet deactivation. Other proposed endothelium- derived relaxing factors include a hyperpolarizing factor, lipooxygenase products, and the cytochrome P450 pathway. Endothelium-derived contracting factors are produced by the cyclooxygenase pathway and by endothelial cells, which produce the peptide endothelin-1, a potent vasoconstrictor that under normal conditions circulates at low levels. The endothelium produces both growth inhibitors— normally dominant—and growth stimuli. Denuded or dysfunctional endothelium leads to a proliferative response and intimal hyperplasia in the vessel wall; moreover, platelets adhere to the site and release potent growth factors. Endothelial dysfunction has numerous causes: Aging is associated with increased formation of contracting factor and decreased relaxing factor; denudation, such as by coronary angioplasty, impairs the capacities of regenerated endothelial cells; oxidized low-density lipoproteins and hypercholesterolemia interfere with nitric oxide production; hypertension morphologically and functionally alters the endothelium; and atherosclerosis markedly attenuates some endothelium- dependent relaxations. For patients with coronary bypass grafts, differences in endotheliumderived vasoactive factors between the internal mammary artery and the saphenous vein may be important determinants of graft function, with the mammary artery having more pronounced relaxations than the saphenous vein and thus a higher patency rate. Am J Hypertens 1993;6:283S-293

Nifedipine inhibits superoxide production induced by pulsatile stretch in human aortic endothelial cells

Dihydropiridine calcium channel blocker nifedipine restores nitric oxide-mediated vasodilation in human hypertension. The mechanims involved have not been fully characterized but may relate to endothelial protection. Mechanical forces such as pulsatile stretch are involved in superoxide anion production. To clarify the effect of nifedipine on the balance between nitric oxide and superoxide anion, human cultured aortic endothelial cells were exposed to pulsatile stretch in the presence and in the absence of this compound. Rhytmic stretching was given for 1 hour by a computerized Flexercell strain unit (10% average elongation, 50 cycles per minute). Superoxide anion production was measured as the superoxide dismutase-inhibitable reduction of cytochrome c. Stretch-induced production of superoxide anion was inhibited in a concentration-dependent manner by nifedipine [6.2±0.9 vs 2.1±0.6* and 4.8±0.4*, 2.4±0.5* nmol/60 min/105 cells for stretch vs control and stetch plus nifedipine (10−7 and 10−6 M), respectively; n=6; *P<0.05 vs stretch]. This antioxidant activity of nifedipine may exert vascular protective effects in human endothelial cells. Thus, nifedipine may affect mechanical forces which, as determinants of the balance between nitric oxide and superoxide anion, are likely to play a key role in the pathophysiology of hypertensive vascular diseas

Structure and reactivity of small arteries in aging

Objective: Increased pulse pressure has been observed in aging subjects, but the impact on the structure and reactivity of small arteries has been scarcely evaluated. Methods: This study presents the modifications of vascular structure and function observed in female rats of 5, 18 and 32 months of age, and their relation to the prevailing hemodynamic status. Geometry and reactivity of perfused and pressurized basilar and mesenteric small arteries were analyzed in vitro using a video dimension analyzer. Results: Mean arterial pressure was similar in the three age groups, and only pulse pressure was increased in the oldest group. Media thickness and cross sectional area increased in basilar and mesenteric arteries of the oldest rats and these structural abnormalities were positively related to pulse pressure but not to mean, systolic or diastolic arterial pressure. Only minor changes of vascular reactivity were noted with age: there was a decreased contraction to angiotensin II in mesenteric arteries and an enhanced contraction to endothelin-1 in the basilar arteries. Conclusion: In conclusion, aging is associated with increased pulse pressure and hypertrophy of basilar and mesenteric resistance arteries, suggesting that this hemodynamic variable may influence cerebral and peripheral vascular structure in agin

Endothelin and cardiac arrhythmias: do endothelin antagonists have a therapeutic potential as antiarrhythmic drugs?

Endothelin-1 (ET-1), the predominant isoform of the ET peptide family and a potent vasoconstrictor, has been shown to aggravate ischemia-induced ventricular arrhythmias. However, there is also evidence that ET-1 may have a direct arrhythmogenic action that is not solely attributable to myocardial ischemia. Proposed mechanisms for the arrhythmogenic effects of ET-1 are prolongation or increased dispersion of monophasic action potential duration, QT prolongation, development of early afterdepolarizations, acidosis, and augmentation of cellular injury. As for an ionic basis for the observed electrophysiologic effects, ET-induced Ca2+ release from intracellular stores, generation of inositol triphosphate, inhibition of delayed rectifier K+ current, and stimulation of the Na+/H+ exchanger may be involved. Recently, some studies have shown that ET receptor antagonists, which promise to be powerful tools in cardiovascular medicine, may also demonstrate antiarrhythmic properties. This review describes the current state of knowledge on the interactions between the ET system and cardiac arrhythmias, and discusses the therapeutic potential of ET antagonists as antiarrhythmic drug