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Circulating immunoreactive endothelin in ischemic heart disease
1First Department of Internal Medicine, Osaka City University Medical School, Japan.
Insights
Plasma endothelin levels significantly increase during acute myocardial infarction (AMI), correlating with cardiac dysfunction and coagulation activation. Levels remained normal in stable angina pectoris patients.
Area of Science:
- Cardiology
- Vascular Biology
- Biochemistry
Background:
- Endothelin (ET) is a potent vasoconstrictor peptide.
- Its role in acute myocardial infarction (AMI) is not fully understood.
- Measuring circulating immunoreactive endothelin (ir-ET) can provide insights into AMI pathophysiology.
Purpose of the Study:
- To investigate circulating immunoreactive endothelin (ir-ET) levels in patients with AMI.
- To compare ir-ET levels in AMI patients with those in stable angina pectoris (SAP) and healthy controls.
- To explore correlations between ir-ET levels and clinical parameters in AMI.
Main Methods:
- Plasma ir-ET levels were measured using radioimmunoassay.
- Study included 9 AMI patients, 10 SAP patients, and 25 healthy controls.
- Correlations were assessed with wall motion abnormality index, thrombin-antithrombin III complex, beta-thromboglobulin, and Killip classification.
Main Results:
- Plasma ir-ET levels were significantly elevated in the acute phase of AMI (3.8 +/- 1.7 pg/ml) compared to controls (0.5 +/- 0.2 pg/ml).
- Elevated ir-ET positively correlated with wall motion abnormality index (r=0.56), thrombin-antithrombin III complex (r=0.55), and beta-thromboglobulin (r=0.39).
- Highest ir-ET levels were observed in AMI patients with Killip class IV; levels were not elevated in SAP patients (0.8 +/- 0.3 pg/ml).
Conclusions:
- Circulating ir-ET levels are increased during the acute phase of AMI.
- Elevated ir-ET in AMI may be linked to cardiac dysfunction, coagulation system activation, and platelet hyperactivity.
- Endothelin may play a significant pathophysiological role in acute myocardial infarction.
Abstract:
Circulating immunoreactive endothelin (ir-ET) was measured in nine patients with acute myocardial infarction (AMI), 10 patients with stable angina pectoris (SAP), and 25 normal control subjects. In patients with AMI, the plasma ir-ET level was elevated in the acute phase and was highest on the day of onset (AMI: 3.8 +/- 1.7 pg/ml, normal control value: 0.5 +/- 0.2 pg/ml). The plasma ir-ET level showed a positive correlation with the wall motion abnormality index (rs = 0.56, p less than 0.01), thrombin-antithrombin III complex (rs = 0.55, p less than 0.01), and beta thromboglobulin (rs = 0.39, p less than 0.05). An especially high plasma ir-ET level was detected in patients in whom the Killip subset was IV. The plasma ir-ET level was not increased in patients with SAP (0.8 +/- 0.3 pg/ml). The plasma ir-ET level is increased in the acute phase of AMI. A pathophysiologic state characterized by cardiac dysfunction, an activated coagulation system, and platelet hyperactivity may be associated with this increase in plasma ir-ET.