Chronic endothelin receptor antagonism prevents coronary vasa vasorum neovascularization in experimental hypercholesterolemia

Objectives The purpose of this study was to test the hypothesis that endothelin (ET) receptor antagonism reduces coronary vasa vasorum neovascularization in experimental hypercholesterolemia. Background Experimental hypercholesterolemia is associated with increased expression of ET-1, an endothelium-derived peptide with vasoconstricting, mitogenic and angiogenic properties, in the coronary arterial wall as well as with vasa vasorum neovascularization. A pathomechanistic role of the endogenous ET system in vasa vasorum neovascularization in hypercholesterolemia has, however, remained uncertain so far. Methods Female domestic pigs were placed on a normal diet (N; N = 7) or on a hypercholesterolemic diet without (HC; N = 6) or with ET-A receptor antagonism (ABT-627, 4 mg/kg/day; HC + ET-A; N = 6). After 12 weeks, coronary vasa vasorum structure was assessed by three-dimensional microscopic computed tomography, expression of vascular endothelial growth factor (VEGF) within the coronary arterial wall by Western blotting and immunostaining. Results Compared with the N group, plasma concentrations of low-density lipoprotein cholesterol were higher in both the HC and HC + ET-A groups (36 ± 3 mg/dl vs. 312 ± 153 mg/dl and 303 ± 113 mg/dl, p < 0.01). Vasa vasorum density was higher in the HC group compared with the N group (4.7 ± 1.8 per mm2 vs. 2.5 ± 1.5 per mm2; p < 0.05) and was preserved in the HC + ET-A group (3.2 ± 0.7 per mm2). In parallel, increase in VEGF expression in the coronary arterial wall in the HC group was preserved in the HC + ET-A group. Conclusions The current study demonstrates that chronic endothelin receptor antagonism prevents the increase in VEGF expression and vasa vasorum density of coronary arteries in experimental hypercholesterolemia. These findings support a role for the endogenous ET system in vasa vasorum neovascularization in early coronary atherosclerosis.