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Endothelin-1 has haemodynamic effects at pathophysiological concentrations in patients with left ventricular
P J Cowburn1, J G Cleland, J D McArthur
1Medical Research Council Clinical Research Initiative in Heart Failure, University of Glasgow, Scotland, UK.
Cardiovascular Research
|December 23, 1998
Summary
Infusing endothelin-1 (ET-1) in patients with left ventricular dysfunction caused systemic vasoconstriction but did not affect pulmonary vasculature. This suggests ET-1 contributes to systemic hemodynamic derangements in heart failure.
Area of Science:
- Cardiovascular Physiology
- Pharmacology
- Heart Failure Pathophysiology
Background:
- Elevated plasma endothelin-1 (ET-1) is observed in chronic heart failure.
- The role of ET-1 in the hemodynamic derangement of heart failure remains unclear.
Purpose of the Study:
- To investigate the effects of exogenous ET-1 on pulmonary and systemic vasculature.
- To determine if ET-1 contributes to hemodynamic changes in patients with left ventricular systolic dysfunction (LVD).
Main Methods:
- Infusion of ET-1 into the pulmonary artery of ten LVD patients.
- Achieving plasma ET-1 concentrations similar to those in heart failure.
- Measuring systemic and pulmonary hemodynamics using catheters and arterial lines.
Main Results:
- Systemic vascular resistance and mean arterial pressure increased significantly with ET-1 infusion.
- Cardiac index decreased, indicating reduced cardiac output.
- Pulmonary artery pressure and pulmonary vascular resistance remained unchanged.
Conclusions:
- Exogenous ET-1 causes systemic vasoconstriction at concentrations found in severe heart failure.
- ET-1 does not appear to cause pulmonary vasoconstriction in this context.
- Findings suggest ET-1 contributes to systemic hemodynamic alterations in heart failure.