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Big endothelin in chronic heart failure: marker of disease severity or genetic determination?

L Spinarová1, J Spinar, A Vasků

  • 11st Internal Cardio-angiological Department, St. Anne's Hospital, Brno, Czech Republic.

International Journal of Cardiology
|January 20, 2004
PubMed

Insights

This study found that while endothelin levels correlate with heart failure severity (NYHA classes), they do not directly link to specific endothelin-1 gene variations. However, certain gene variants are associated with pulmonary congestion in heart failure patients.

Area of Science:

  • Cardiology
  • Genetics
  • Biochemistry

Background:

  • Chronic heart failure (CHF) poses a significant health burden, necessitating improved diagnostic and prognostic markers.
  • Endothelin-1 (ET-1) is a potent vasoconstrictor implicated in cardiovascular diseases, including heart failure.
  • Genetic variations in the ET-1 gene may influence disease susceptibility and progression.

Purpose of the Study:

  • To compare plasma levels of big endothelin (big ET-1) and endothelin-1 (ET-1) with noninvasive parameters in chronic heart failure (CHF) patients.
  • To investigate the association between ET-1 and big ET-1 plasma levels and common ET-1 gene polymorphisms (-3A/-4A and G (8002) A).
  • To correlate noninvasive CHF parameters (cardiothoracic index, NYHA class, pulmonary congestion, ejection fraction) with ET-1 gene polymorphisms.

Main Methods:

  • Plasma concentrations of big ET-1 and ET-1 were measured in 124 CHF patients.
  • Genotyping for ET-1 gene polymorphisms (-3A/-4A and G (8002) A) was performed.
  • Noninvasive parameters including cardiothoracic index (CTI), NYHA classification, pulmonary congestion (PC), and ejection fraction (EF) were assessed.

Main Results:

  • Significant differences in big ET-1 and ET-1 plasma levels were observed across NYHA functional classes (II-IV).
  • No significant associations were found between plasma ET-1/big ET-1 levels and the studied ET-1 gene polymorphisms.
  • Patients with CHF and CTI > 60% showed an increased prevalence of ET-1 8002A genotypes.
  • A significant difference in genotype distribution and allelic frequency of the -3A/-4A polymorphism was noted in patients with CTI > 60% and pulmonary congestion, with the 3A allele being more frequent.

Conclusions:

  • Plasma levels of big ET-1 and ET-1 are significantly correlated with the severity of chronic heart failure as indicated by NYHA classification.
  • The studied ET-1 gene polymorphisms (-3A/-4A and G (8002) A) are not directly associated with plasma ET-1 or big ET-1 levels in CHF patients.
  • The -3A/-4A ET-1 polymorphism may be associated with the development of pulmonary congestion in CHF patients with increased cardiothoracic index, suggesting a potential genetic predisposition.

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