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Circulation, Vol 85, 504-509, Copyright © 1992 by American Heart Association
RJ Cody, GJ Haas, PF Binkley, Q Capers and R Kelley
BACKGROUND. Endothelin is a family of potent vasoconstrictor peptides of
vascular endothelial origin. Although it has been proposed that the
vasoconstrictor effects of endothelin are produced at the local vascular
level, increased plasma concentration of endothelin has been identified in
cardiovascular disorders. METHODS AND RESULTS. We tested whether
immunoreactive endothelin-1 could be detected by radioimmunoassay in plasma
of congestive heart failure patients and whether levels correlated with
hemodynamic characteristics. Twenty congestive heart failure patients (New
York Heart Association class II- IV) were sampled in the morning after an
overnight fast, before medication. Cardiac index was decreased to 2.14 +/-
0.45 l/m/m2, and pulmonary wedge pressure was increased to 22 +/- 7 mm Hg.
The ranges of pulmonary pressures were: systolic, 22-100 mm Hg, mean, 13-61
mm Hg, and diastolic, 8-42 mm Hg. The endothelin-1 level was 9.07 +/- 4.13
pg/ml (range, 4-19 pg/ml), which was increased compared with 12 normals
(3.7 +/- 0.6 pg/ml; range, 2.8-4.7 pg/ml); the difference was statistically
significant (p less than 0.0001). Endothelin-1 significantly correlated
with pulmonary pressures (systolic, r = 0.78; mean, r = 0.80; diastolic, r
= 0.77; all p less than 0.003) and pulmonary vascular resistance (r = 0.65,
p less than 0.01). Endothelin- 1 strongly correlated with the resistance
ratio (pulmonary vascular resistance/systemic vascular resistance) (r =
0.88, p less than 0.0001). Stepwise multiple regression analysis confirmed
the significance of these observations. CONCLUSIONS. Elevated
immunoreactive endothelin-1 specifically correlated with the extent of
pulmonary hypertension in congestive heart failure patients. Whether
endothelin-1 is a regional mediator of pulmonary hypertension or a marker
for its occurrence requires additional evaluation.
ARTICLES
Plasma endothelin correlates with the extent of pulmonary hypertension in patients with chronic congestive heart failure [published erratum appears in Circulation 1993 Mar;87(3):1064]
Department of Medicine, Ohio State University Hospitals, College of Medicine, Columbus, Ohio 43210.
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