Can increased intestinal permeability and low-grade endotoxemia be the triggering pathogenesis in isolated coronary artery ectasia?

Abstract

Purpose Isolated coronary artery ectasia (ICAE) is a rare coronary artery disease (CAD) encountered during coronary angiography. Although many mechanisms have been suggested today that may be associated with ICAE, the underlying pathogenesis has not been fully understood. In this study, we aimed to reveal the possible relationship between intestinal permeability and ICAE. Methods Of the 12 850 patients who underwent coronary angiography, 138 consecutive patients with ICAE and 140 age- and sex-matched subjects with normal coronary arteries as the control group and 140 subjects with stenotic CAD were included in the study. Results Serum zonulin and lipopolysaccharide levels were significantly higher in patients with ICAE than in the control group and CAD group. Additionally, zonulin and lipopolysaccharide levels were significantly higher in the CAD group than in the ICAE group. In the correlation analysis, serum zonulin levels were correlated with the mean diameter and length of the ecstatic segment. In multivariate analysis, zonulin and lipopolysaccharide were identified as independent predictors for ICAE. Conclusion These results suggest that there may be a pathophysiological relationship between increased intestinal permeability and ICAE.

Qual a Eficácia do Índice Imune Inflamatório Sistêmico na Etiopatogenia da Ectasia Isolada da Artéria Coronária?

“…A ectasia isolada da artéria coronária (EIAC) é frequentemente encontrada na prática clínica com métodos de imagem invasivos crescentes, e nosso conhecimento sobre sua etiologia, prognóstico e abordagens de tratamento está aumentando diariamente. 1 , 2 Lemos com grande interesse o recente estudo retrospectivo de Dindas et al, 3 que trata da relação entre o Índice de Inflamação Imunológica Sistêmica (IIS) e EIAC. 3 Foi sugerido que neutrófilos, plaquetas e linfócitos IIS coletados em uma única fração podem ser um bom indicador de inflamação e resposta imune.…”

“…Isolated coronary artery ectasia (ICAE) is frequently encountered in clinical practice with increasing invasive imaging methods, and our knowledge about its etiology, prognosis, and treatment approaches is increasing daily. 1 , 2 We read with great interest the recent retrospective study of Dindas et al, 3 which deals with the relationship between the Systemic Immune Inflammation Index (SII) and ICAE. 3 It has been suggested that SII neutrophils, platelets, and lymphocytes collected in a single fraction may be a good indicator of inflammation and immune response.…”