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Increased plasma endothelin concentrations in patients with acute heart failure after myocardial infarction
M Nakamura1, N Arakawa, H Yoshida
1Second Department of Internal Medicine, Iwate Medical University, Japan.
Insights
Plasma endothelin (ET) levels are elevated in patients with congestive heart failure or severe ventricular dysfunction, but not solely due to myocardial infarction or ischemia alone.
Area of Science:
- Cardiology
- Endocrinology
- Biochemistry
Background:
- Endothelin (ET) is a potent vasoconstrictor peptide.
- Its role in acute myocardial infarction (MI) and heart failure is not fully understood.
- Investigating ET levels in various cardiovascular conditions is crucial.
Purpose of the Study:
- To examine the relationship between plasma endothelin concentrations and clinical characteristics in acute myocardial infarction (MI).
- To compare ET levels in patients with MI, unstable angina, chronic heart disease, and healthy individuals.
- To determine if ET levels correlate with pulmonary congestion or hemodynamic parameters in MI patients.
Main Methods:
- Plasma endothelin (ET) concentrations were measured in 31 patients with acute MI.
- ET levels were also assessed in 10 healthy subjects, 9 with unstable angina, and 20 with chronic heart disease.
- Clinical characteristics, including pulmonary congestion and hemodynamic parameters, were recorded.
Main Results:
- Plasma ET levels were significantly higher in MI patients with pulmonary congestion compared to those without (1.61 +/- 0.29 vs 1.21 +/- 0.33 fmol/ml, p < 0.01).
- No significant differences in ET levels were found between cardiac and peripheral sampling sites.
- ET levels did not differ significantly between uncomplicated MI patients, unstable angina patients, and healthy subjects.
- Elevated ET levels were observed in patients with decompensated chronic heart failure but not in those without pulmonary congestion.
Conclusions:
- Plasma endothelin concentrations are elevated in the presence of congestive heart failure or severe ventricular depression.
- Myocardial ischemia or infarction alone does not appear to persistently increase plasma ET levels.
- ET may serve as a biomarker for the severity of heart failure rather than acute ischemia.
Abstract:
We have investigated the relationship between plasma endothelin (ET) concentrations and several clinical characteristics in 31 patients with acute myocardial infarction (MI). ET levels were also measured in 10 age-matched healthy subjects, 9 patients with unstable angina, and 20 patients with chronic heart disease. In patients with MI, although no significant relationship was observed between plasma ET concentrations and measured hemodynamic parameters, plasma levels were higher in patients with pulmonary congestion than in those without this complication (1.61 +/- 0.29 vs 1.21 +/- 0.33 fmol/ml; p < 0.01). No significant difference in plasma ET levels was found between cardiac and peripheral sampling sites (pulmonary artery; 1.07 +/- 0.28, right atrium; 1.02 +/- 0.28, peripheral artery; 1.12 +/- 0.23, peripheral vein; 1.14 +/- 0.38 fmol/ml: N.S.), or among patients with uncomplicated MI, unstable angina (1.00 +/- 0.32 fmol/ml), and healthy subjects (1.01 +/- 0.29 fmol/ml). Increased level were observed in patients with decompensated heart failure due to chronic heart disease, but were not found in patients without pulmonary congestion (1.62 +/- 0.60 vs 1.11 +/- fmol/ml; p < 0.01). These observations suggest that plasma ET concentrations are elevated in the presence of congestive heart failure or severe ventricular depression, but are not persistently increased by myocardial ischemia per se.