Abstract: Aim Endothelial dysfunction plays critical roles in acute and chronic complications after percutaneous transluminal coronary angioplasty (PTCA).Coronary endo thelial injury and the release of vasoactive substances induced by PTCA were investigated.Methods Forty-four patients with ischemic heart disease who underwent elective PTCA to isolated stenotic lesions in left coronary arteries were examined.Eleven patients received balloon angioplasty (BA), fourteen percutaneous int ravascular brachtheraphy (VBT), and nineteen stent implantation.Blood samples were drawn from the coronary sinus immediately before and 4 h and 24 h after PTCA.Levels of plasma endo thelin 1 (ET-1), angiotensin (ANG) Ⅱ, von Willebrand factor (vWF), and thrombomodulin (TM) were measured.Seven subjects who underwent diag nostic coronary angiopg raphy (CAG) were used as control group.Results In all patients, ET-1 levels in the coronary sinus blood significantly increased immediately after PTCA.ANG Ⅱ levels and vWF activity showed significantly increased immmediately 4 h after PTCA.Changes in levels of these markers were similar among the BA, VBT and stent groups.TM levels were elevated in all groups of patients, including those simply undergoing diag nostic CAG.Conclusion Changes in ET-1, ANG Ⅱ and vWF levels in the coronary sinus ref lect coronary endo thelial injury induced by PTCA.

Key words: coronary intervention, endothelium, vasospasm, restenosis