The relationship of serotonin level with syndrome X and coronary artery disease

Year 2024, Volume: 6 Issue: 3, 203 - 209, 28.05.2024

İbrahim Aktaş , Hasan Arı , Mehmet Demir , Yasemin Üstündağ

https://doi.org/10.38053/acmj.1415710

Abstract

Aims: Platelets secrete serotonin (5-hydroxytryptamine) which has several effects on the vascular wall and promotes thrombogenesis, mitogenesis, and proliferation of smooth muscle cells. We thought serotonin which relation with coronary artery disease (CAD) has been shown in various data might be important for etiology and diagnosis of cardiac syndrome X (CSX) which’s physiopathology has not been elucidated yet. The aim of the study is to investigate relationship between serotonin level with CSX and stabile coronary artery disease.
Methods: Serum serotonin levels were measured by micro ELİSA procedure in three group of patients who underwent coronary angiography. First group consisted of 30 patients (17 male, 13 female, mean age 60.5±6.1) who has diagnosed CSX, second group consisted 22 patients (11 male, 11 female, mean age 60.5±6.1) who has diagnosed stable coronary artery disease and third group consisted 28 patients (10 male, 18 female, mean age 56.6±10) comprised the control group. All three groups of patients demographic, biochemical, hematological and echocardiographic data were recorded.
Results: The three groups were similar with respect to age, sex, body mass index and the frequencies of diabetes mellitus and smoking(p>.016). We detected average serum serotonin levels 49.7 ng/ml in syndrome X group, 41.8 ng/ml in CAD group and 44.8 ng/ml in control group. These values are not statistically significant between the groups monitored(p=.91).
Conclusion: The serotonin level of of CSX patients, stabile coronary artery disease patients and control group patients were measured in the serum which seperated from peripheral venous blood. Statistically significant difference in serum serotonin levels couldn’t be detected between these three group.

Keywords

Serotonin, Cardiac Syndrome X, Coronary Artery Disease

References

• Galassi AR, Kaski JC, Pupita G, Vejar M, Crea F, Maseri A. Lack of evidence for alphaadrenergic receptor-mediated mechanisms in the genesis of ischemia in syndrome X. Am J Cardiol. 1989; 64(5):264-269. doi: 10.1016/0002-9149(89)90517-1
• Camici PG, Crea F. Coronary microvascular dysfunction. New Eng J Med. 2007;356(8):830-840.
• Crea F, Lanza GA. Angina pectoris and normal coronary arteries: cardiac syndrome X. Heart. 2004;90(4):457-463. doi: 10.1136%2Fhrt.2003.020594
• Ashton JH, Benedict CR, Fitzgerald C, et al. Serotonin as a mediator of cyclic flow variations in stenosed canine coronary arteries. Circulation. 1986;73(3):572-578. doi: 10.1161/01.cir.73.3.572
• Kawai C. Pathogenesis of acute myocardial infarction. Novel regulatory systems of bioactive substances in the vessel wall. Circulation. 1994;90(2):1033-1043. doi: 10.1161/01.cir.90.2.1033
• Vikenes K, Farstad M, Nordrehaug JE. Serotonin is associated with coronary artery disease and cardiac events. Circulation. 1999;100(5):483-489. doi: 10.1161/01.cir.100.5.483
• Cooper JR, Bloom FE, Roth RH. The biochemical basis of neuropharmacology. Oxford University Press: 2003.
• Wolf N. Thrombosis and arteriosclerosis. Br Med Bull. 1978; 34:137-142.
• Lewis JC, Kottke BA. Endothelial damage and thrombocyte adhesion in pigeon atherosclerosis. Science 1977;196(4293):1007-1009. doi: 10.1126/science.860128
• Gorog P, Kovacs IB. Lipid peroxidation by activated platelets: a possible link between thrombosis and atherogenesis. Atherosclerosis. 1995;115(1):121-128. doi: 10.1016/0021-9150(94)05506-e
• Bush LR, Campbell WB, Kern K, et al. The effects of alpha 2-adrenergic and serotonergic receptor antagonists on cyclic blood flow alterations in stenosed canine coronary arteries. Circulat Res. 1984;55(5):642-652. doi: 10.1161/01.res.55.5.642
• Eidt J, Ashton J, Golino P, McNatt J, Buja LM, Willerson JT. Thromboxane A2 and serotonin mediate coronary blood flow reductions in unsedated dogs. Am J Physiol-Heart Circulat Physiol. 1989;257(3):H873-H882. doi: 10.1152/ajpheart.1989.257.3.h873
• Golino P, Ashton J, Buja L, et al. Local platelet activation causes vasoconstriction of large epicardial canine coronary arteries in vivo. Thromboxane A2 and serotonin are possible mediators. Circulation. 1989;79(1):154-166. doi: 10.1161/01.cir.79.1.154
• Nemecek GM, Coughlin SR, Handley DA, Moskowitz MA. Stimulation of aortic smooth muscle cell mitogenesis by serotonin. Proceed National Acad Sci. 1986;83(3):674-678. doi: 10.1073/pnas.83.3.674
• Seuwen K, Pouysségur J. Serotonin as a growth factor. Biochem Pharmacol. 1990;39(6):985-990. doi: 10.1016/0006-2952(90)90276-q
• Clerck FD, Symoens J, Janssen P. Vascular protection by ketanserin, a 5-HT2 serotonergic receptor antagonist? Platelets. 1991;2(3):163-166. doi: 10.3109/09537109109006029
• Willerson JT, Yao SK, McNatt J, et al. Frequency and severity of cyclic flow alternations and platelet aggregation predict the severity of neointimal proliferation following experimental coronary stenosis and endothelial injury. Proceed National Acad Sci. 1991;88(23):10624-10628. doi: 10.1073/pnas.88.23.10624
• Pakala R, Willerson JT, Benedict CR. Mitogenic effect of serotonin on vascular endothelial cells. Circulation. 1994;90(4):1919-1926. doi: 10.1161/01.cir.90.4.1919
• Willerson JT, Golino P, Eidt J, Campbell WB, Buja LM. Specific platelet mediators and unstable coronary artery lesions. Experimental evidence and potential clinical implications. Circulation. 1989;80(1):198-205. doi: 10.1161/01.cir.80.1.198
• Hirsh PD, Hillis LD, Campbell WB, Firth BG, Willerson JT. Release of prostaglandins and thromboxane into the coronary circulation in patients with ischemic heart disease. New Eng J Med. 1981;304(12):685-691. doi: 10.1056/nejm198103193041201
• van den Berg EK, Schmitz J, Benedict C, Malloy CR, Willerson JT, Dehmer GJ. Transcardiac serotonin concentration is increased in selected patients with limiting angina and complex coronary lesion morphology. Circulation. 1989;79(1):116-124. doi: 10.1161/01.cir.79.1.116
• Golino P, Piscione F, Benedict CR, et al. Local effect of serotonin released during coronary angioplasty. New Eng J Med. 1994;330(8):523-528. doi: 10.1056/nejm199402243300802
• Brum JM, Sufan Q, Lane G, Bove AA. Increased vasoconstrictor activity of proximal coronary arteries with endothelial damage in intact dogs. Circulation. 1984;70(6):1066-1073. doi: 10.1161/01.cir.70.6.1066
• Lamping KG, Marcus ML, Dole WP. Removal of the endothelium potentiates canine large coronary artery constrictor responses to 5-hydroxytryptamine in vivo. Circulat Res. 1985;57(1):46-54. doi: 10.1161/01.res.57.1.46
• Chu A, Cobb FR. Vasoactive effects of serotonin on proximal coronary arteries in awake dogs. Circulat Res. 1987;61(5_supplement):II81-II87.
• Cocks T, Angus J. Endothelium-dependent relaxation of coronary arteries by noradrenaline and serotonin. Nature. 1983;305(5935):627-630. doi: 10.1038/305627a0
• Cappelli-Bigazzi M, Lamping KG, Nuno DW, Harrison DG. Leukocyte and platelet derived factors augment canine coronary constriction to serotonin. Am J Physiol-Heart Circulat Physiol. 1990;259(4): H1161-H1170. doi: 10.1152/ajpheart. 1990.259.4.h1161
• Golino P, Piscione F, Willerson JT, et al. Divergent effects of serotonin on coronaryartery dimensions and blood flow in patients with coronary atherosclerosis and control patients. New Eng J Med. 1991;324(10):641-648. doi: 10.1056/nejm199103073241001
• McFadden EP, Clarke JG, Davies GJ, Kaski JC, Haider AW, Maseri A. Effect of intracoronary serotonin on coronary vessels in patients with stable angina and patients with variant angina. New Eng J Med. 1991;324(10):648-654. doi: 10.1056/nejm199103073241002
• Shimokawa H, Vanhoutte PM. Impaired endothelium-dependent relaxation to aggregating platelets and related vasoactive substances in porcine coronary arteries in hypercholesterolemia and atherosclerosis. Circulat Res. 1989;64(5):900-914. doi: 10. 1161/01.res.64.5.900
• Cohen R, Shepherd J, Vanhoutte P. 5-Hydroxytryptamine can mediate endotheliumdependent relaxation of coronary arteries. Am J Physiol-Heart Circulat Physiol. 1983;245(6):H1077-H1080. doi: 10.1152/ajpheart.1983.245.6.h1077
• Hara H, Osakabe M, Kitajima A, Tamao Y, Kikumoto R. MCI-9042, a new antiplatelet agent is a selective S2-serotonergic receptor antagonist. Thrombosis Haemostasis. 1991;65(04):415-420.
• Tanaka T, Fujita M, Nakae I, et al. Improvement of exercise capacity by sarpogrelate as a result of augmented collateral circulation in patients with effort angina. J Am Coll Cardiol. 1998;32(7):1982-1986. doi: 10.1016/s0735-1097(98)00496-3
• Al Suwaidi J, Higano ST, Holmes DR, Lerman A. Pathophysiology, diagnosis, and current management strategies for chest pain in patients with normal findings on angiography. Mayo Clinic Proceed. 2001;76(8):813-822.
• Hurst T, Olson TH, Olson LE, Appleton CP. Cardiac syndrome X and endothelial dysfunction: new concepts in prognosis and treatment. Am J Med. 2006;119(7):560-566. doi: 10.1016/j.amjmed.2005.07.009
• Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004;109(23_suppl_1):III-27-III-32. doi: 10.1161/01.CIR.0000131515.03336.f8