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Relation of elevated plasma endothelin in congenital heart disease to increased pulmonary blood flow

J A Vincent1, R D Ross, J Kassab

  • 1Division of Cardiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit 48201.

The American Journal of Cardiology
|May 15, 1993
PubMed

Insights

Endothelin-1 (ET) is elevated in children with congenital heart defects and increased pulmonary blood flow. This study found higher ET levels in patients with left-to-right shunts, linked to greater pulmonary blood flow, not pulmonary artery pressure.

Area of Science:

  • Cardiology
  • Pediatrics
  • Endocrinology

Background:

  • Endothelin-1 (ET) is a potent vasoconstrictor.
  • ET levels are elevated in children with pulmonary hypertension and congenital heart defects.
  • The relationship between pulmonary blood flow and ET in this population requires further investigation.

Purpose of the Study:

  • To evaluate the effect of pulmonary blood flow on ET concentrations in children with congenital heart defects.
  • To determine if elevated ET is associated with increased pulmonary blood flow or pulmonary hypertension.

Main Methods:

  • Collected peripheral blood samples from 35 pediatric patients undergoing cardiac catheterization.
  • Measured plasma ET concentrations using radioimmunoassay.
  • Classified patients into groups based on pulmonary blood flow (Qp/Qs ≥ 1.5) and analyzed ET levels in relation to flow and pressure.

Main Results:

  • ET concentrations were significantly higher in patients with increased pulmonary blood flow (Group A) compared to those without (Group B).
  • Patients with increased pulmonary blood flow also had higher pulmonary blood flow and pulmonary artery pressure.
  • No significant difference in ET concentrations was observed between patients with and without pulmonary hypertension within the increased flow group.

Conclusions:

  • ET is elevated in children with congenital heart disease and left-to-right shunts.
  • The elevation in ET appears to be related to increased pulmonary blood flow, independent of pulmonary artery pressure.
  • This suggests a potential role for ET in the hemodynamic alterations associated with congenital heart defects and increased pulmonary perfusion.

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