| Background:Coronary artery disease(CAD) has become worldwide common disease and seriously threatened human being's health. Since Doctor Gruentzing successfully applied the technique of percutaneous transluminal coronary angioplasty (PTCA) to the clinical treatment at first in September of 1977, coronary heart disease entered a new period of interventional treatment. However, PCI cannot eliminate radically the risk factors and restore unreversible myocardial ischemic damage, and slightly higher rate of restenosis after PTCA lower its clinical effect and restrict its clinical application to a certain extent. Pathogenesis of restenosis after PCI has not been illuminated thoroughly. In recent years clinical and experimental studies have confirmed that exaggerated neointimal thickening and muscle cell transfer induced by vascular injury caused by intervention process are the main pathology character of restenosis after PCI, along with the vascular injury caused by intervention process, the release of vasoactive substances have an effect on restenosis. Among the vasoactive substances endothelin-1 was closely related to restenosis after PTCA, and to antagonize the biologic action of ET-1 maybe is a new path to prevent and cure restenosis after PTCA . Adrenomedullin(ADM) is a novel vasoactive peptide originally isolated from human pheochromocytoma tissue in 1993. The actions of ADM are including not only vasodilatation> reduction of arterial pressure > inhibition of vascular smooth muscle cell(VSMC) transference and proliferation but also diuretic and natriuretic effects, inhibition of aldosterone secretion, ameliorate ventricle remodeling. So adrenomedullin maybe play an important role in the occur and development of cardiovascular disease. Several experimental studies have shown that adrenomedullin not only has anti-restenosis characteristic but also coadjust with other active substances which were related to restenosis after PCI. Clinical researchs also showed that PCI produce increased plasmavasoconstrictors level, meanwhile ADM increased for compensation regulation. These researchs suggest that the plasma ADM concentrations in the procedure of PCI may affect the restenosis after procedure. We examined the dynamic changes of ADM ET-1 in 70 consecutive coronary artery disease patients who underwent PCI, and discussed the relationship between vascular active peptides with restenosis after PCI, through that we hope to show a new research field about prevention and cure of restenosis.Objective:1. We have studied the variation of ADM in the coronary sinus in patients with CAD, and the aim of this study was to evaluate clinical signification and action of ADM in the process of CAD progression.2. By studying the variation of ADM ET-1 in the coronary sinus during PCI and the relationship between ADM and ET-1, we illustrate this pair of vasoactive substances interactional mechanism in the process of PCI.3. By studying the relationship between vasoactive substances and restenosis after PCI, it shows that these vasoactive substances act and antagonize one another in the process of restenosis after PCI, which can provide theorical and clinically basis for prevention and cure of restenosis after PCI.Methods:1. The study group comprise 70 consecutive patients who underwent both coronary angioplasty and stenting, at the same time 20 angiographically normal patients as controls. Age, gender, smoking, hypertension, diabetes, cholesterol, HDL-C, LDL-C, and LVEF were recoded in every patients in detail.2. Blood samples were obtained from the coronary sinus and femoral artery immediately before and after angiography, immediately after PTCA, 10 min after procedures. After centrifugation at 3000rpm at 4C for 15min,the plasma was decanted and stored at -70 C until analysis. Plasma ADM, ET-1 levels of 70 patients with CAD and 20 control subjects were measured by radioimmunoassay.3. Angiographic and procedural characteristics of patients were recoded in detail. 3, 6, 12 months After PCI...
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