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[Big endothelin and chronic heart failure]
J Spinar1, L Spinarová, J Vítovec
1II. interní klinika FN u sv. Anny, Brno.
Insights
Plasma levels of big endothelin and endothelin-1 are significantly elevated in chronic heart failure patients. These markers show increased levels correlating with disease severity and pulmonary congestion, suggesting diagnostic utility.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Context:
- Chronic heart failure (CHF) management relies on accurate prognostic and diagnostic tools.
- Current non-invasive parameters for CHF assessment have limitations.
- Endothelin peptides are implicated in cardiovascular pathophysiology.
Purpose:
- To evaluate the diagnostic significance of plasma big endothelin and endothelin-1 levels in patients with chronic heart failure.
- To compare the efficacy of these endothelin markers against established non-invasive parameters in CHF assessment.
- To determine the correlation between endothelin levels and heart failure severity (NYHA class) and pulmonary congestion.
Summary:
- A study of 124 patients revealed significantly elevated plasma levels of big endothelin and endothelin-1 in those with chronic heart failure compared to healthy individuals.
- Patients in NYHA class IV exhibited a six-fold increase in these markers versus NYHA class II-III, while even milder CHF stages showed doubled levels.
- Elevated endothelin levels were also observed in patients with interstitial pulmonary edema, indicating a link to fluid overload.
Impact:
- Plasma endothelin assessment demonstrates high sensitivity, suggesting its potential integration into routine diagnostic protocols for chronic heart failure.
- These findings highlight big endothelin and endothelin-1 as promising biomarkers for stratifying heart failure severity and guiding clinical management.
- The study underscores the role of the endothelin system in the pathophysiology of heart failure and pulmonary complications.
Abstract:
In a group of 124 patients the authors investigated the importance of assessment of plasma levels of big endothelin and endothelin 1 in patients with chronic heart failure as compared with other currently used non-invasive parameters. A six fold increase of plasma levels of both substances was found in patients in functional class NYHA IV as compared with patients in class NYHA II-III. But even patients in the milder stage of NYHA had twice as high values as compared with the standard of the healthy population. Similarly patients with interstitial pulmonary oedema had a twice as high level of both parameters as compared with patients who had a normal finding on X-ray or merely a redistribution of the pulmonary vascularization. The sensitivity of assessment of plasma levels is such that this examination could become part of the basic diagnosis.