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Prognostic value of plasma soluble intercellular adhesion molecule-1 and endothelin-1 concentration in patients with
T Tsutamoto1, T Hisanaga, D Fukai
1First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
Insights
Plasma endothelin-1 (ET-1) and soluble intercellular adhesion molecule-1 (sICAM-1) levels correlate with congestive heart failure (CHF) severity. Higher levels indicate poorer prognosis, offering valuable insights for patient survival prediction.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Congestive heart failure (CHF) is associated with increased mortality.
- Prognostic markers are crucial for managing CHF patients.
- Endothelin-1 (ET-1) and soluble intercellular adhesion molecule-1 (sICAM-1) are implicated in cardiovascular disease.
Purpose of the Study:
- To investigate the relationship between plasma ET-1 and sICAM-1 levels and survival in CHF patients.
- To determine if ET-1 and sICAM-1 provide additional prognostic information beyond established clinical and biochemical markers.
Main Methods:
- Plasma levels of ET-1 and sICAM-1 were measured in 102 CHF patients (left ventricular ejection fraction [LVEF] < 0.45).
- Patients were followed for over 18 months.
- Correlation analysis was performed between ET-1, sICAM-1, LVEF, and CHF severity (New York Heart Association functional class).
Main Results:
- Plasma sICAM-1 and ET-1 levels increased significantly with CHF severity.
- Both ET-1 and sICAM-1 levels showed a significant negative correlation with LVEF.
- A positive correlation was found between plasma ET-1 and sICAM-1 levels.
- In a subset of patients, treatment led to decreased ET-1 and sICAM-1 levels with improved symptoms.
Conclusions:
- Plasma ET-1 and sICAM-1 levels are elevated in CHF and correlate with disease severity and reduced LVEF.
- These biomarkers may offer additional prognostic value for predicting survival in CHF patients.
- Monitoring ET-1 and sICAM-1 could aid in risk stratification and treatment guidance for CHF.
Abstract:
We tested the hypothesis that plasma endothelin-1 (ET-1) and soluble intercellular adhesion molecule-1 (sICAM-1) in patients with congestive heart failure (CHF) are related to subsequent survival, and assessed whether the measurements of these substances provide additional prognostic information to that obtained from clinical and biochemical variables previously known to be associated with high mortality. Plasma levels of sICAM-1 and ET-1 were measured in 102 patients with CHF (left ventricular ejection fraction [LVEF] < 0.45), and patients were followed up for > 18 months. The plasma level of sICAM-1 increased with the severity of CHF (normal, 149 +/- 10 ng/ml, mild CHF [New York Heart Association functional class II], 207 +/- 9.4 ng/ml, severe CHF [functional class III or IV], 293 +/- 18 ng/ml). The plasma level of ET-1 also increased with the severity of CHF (normal, 1.5 +/- 0.2 pg/ml, mild CHF, 2.1 +/- 0.1 pg/ml, severe CHF, 4.0 +/- 0.4 pg/ml). Plasma levels of both sICAM-1 and ET-1 decreased after treatment in 14 patients, with improvements in symptoms (from functional class IV to II) during the follow-up period. There was a significant positive correlation between the plasma level of ET-1 and plasma sICAM-1 (r = 0.44, p < 0.001). A significant negative correlation was observed between LVEF and plasma ET-1 (r = -0.34, p < 0.001), and plasma sICAM-1 (r = -0.36, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)