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Pulmonary and systemic responses to exogenous endothelin-1 in patients with left ventricular dysfunction
P J Cowburn1, J G Cleland, J D McArthur
1Medical Research Council Clinical Research Initiative in Heart Failure, University of Glasgow, Scotland.
Journal of Cardiovascular Pharmacology
|May 22, 1998
Summary
Endothelin-1 (ET-1) infusion in patients with left ventricular systolic dysfunction (LVD) caused systemic vasoconstriction, increasing blood pressure and vascular resistance. However, ET-1 did not affect pulmonary artery pressure or resistance in these patients.
Area of Science:
- Cardiovascular Physiology
- Endocrinology
Background:
- Elevated plasma endothelin-1 (ET-1) levels are observed in chronic heart failure (CHF).
- ET-1 levels correlate with pulmonary hemodynamic measurements in CHF patients.
Purpose of the Study:
- To investigate the effects of exogenous ET-1 on the pulmonary vasculature.
- To assess ET-1's impact on patients with left ventricular systolic dysfunction (LVD), including those with heart failure.
Main Methods:
- Infusion of ET-1 (1, 5, 15 pmol/min) into the pulmonary artery of 10 LVD patients.
- Measurement of systemic and pulmonary hemodynamics using thermodilution catheter and arterial line.
- Assessment of local pulmonary blood flow via intravascular Doppler and angiography in a subset of patients.
Main Results:
- ET-1 infusion caused a dose-dependent increase in mean arterial pressure and systemic vascular resistance.
- Cardiac index decreased significantly with ET-1 infusion.
- No significant changes were observed in mean pulmonary artery pressure or pulmonary vascular resistance.
Conclusions:
- Exogenous ET-1 induces systemic vasoconstriction in patients with LVD.
- ET-1 does not appear to cause pulmonary vasoconstriction in this patient population.