Endothelial Cell-Derived Extracellular Vesicles Allow to Differentiate Between Various Endotypes of INOCA: A Multicentre, Prospective, Cohort Study

Aleksandra Gąsecka; Piotr Szolc; Edwin van der Pol; Łukasz Niewiara; Bartłomiej Guzik; Paweł Kleczyński; Mariusz Tomaniak; Emilia Figura; Mateusz Zaremba; Marcin Grabowski; Janusz Kochman; Jacek Legutko; Łukasz Kołtowski

doi:10.1007/s12265-024-10575-x

Endothelial Cell-Derived Extracellular Vesicles Allow to Differentiate Between Various Endotypes of INOCA: A Multicentre, Prospective, Cohort Study

J Cardiovasc Transl Res. 2024 Dec 5. doi: 10.1007/s12265-024-10575-x. Online ahead of print.

Authors

Aleksandra Gąsecka^{1

2}, Piotr Szolc^{3

4}, Edwin van der Pol^{5

6}, Łukasz Niewiara^{4

7}, Bartłomiej Guzik^{4

7}, Paweł Kleczyński^{4

7}, Mariusz Tomaniak⁸, Emilia Figura⁸, Mateusz Zaremba⁸, Marcin Grabowski⁸, Janusz Kochman⁸, Jacek Legutko^{4

7}, Łukasz Kołtowski⁸

Affiliations

¹ 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland. gaseckaa@gmail.com.
² Amsterdam Vesicle Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. gaseckaa@gmail.com.
³ Department of Emergency Medicine, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
⁴ Clinical Department of Interventional Cardiology, Saint John Paul II Hospital, Krakow, Poland.
⁵ Amsterdam Vesicle Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁶ Amsterdam UMCBiomedical Engineering & PhysicsLaboratory of Experimental Clinical Chemistry, University of Amsterdam, Amsterdam Cardiovascular Sciences, Atherosclerosis & Ischemic Syndromes, Meibergdreef 9, Amsterdam, The Netherlands.
⁷ Faculty of Medicine, Institute of Cardiology, Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland.
⁸ 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.

PMID: 39638955
DOI: 10.1007/s12265-024-10575-x

Abstract

Ischemia and non-obstructive coronary artery disease (INOCA) might be due to coronary microvascular dysfunction (CMD), vasospastic angina (VSA) or both. We compared plasma concentration of various extracellular vesicles (EVs) in patients with different INOCA endotypes. Patients were divided into those with INOCA (CMD, VSA, mixed CMD + VSA) and non-anginal chest pain. Plasma concentrations of EVs were measured using flow cytometry. Out of 96 patients included, 34 had CMD (35%), 15 VSA (16%), 24 mixed endotype (25%) and 23 non-anginal chest pain (24%). Patients with INOCA had lower ratio of endothelial EVs (CD144 +) to total EVs, compared to patients with non-anginal pain (p = 0.027). Patients with mixed endotype had lower ratio of endothelial EVs (CD144 +) to total EVs, compared to CMD (p = 0.008), VSA (p = 0.014) and non-anginal pain (p < 0.001). Decreased ratio of endothelial EVs (CD144 +) to total EVs might serve as a "circulating footprint" of the mixed INOCA endotype.

Keywords: Coronary microcirculatory disease; INOCA; Vasospastic angina.