Key result
Severe chronic heart failure was associated with elevated peripheral venous endothelin concentrations compared to healthy volunteers.
Why the study?
Are plasma endothelin concentrations elevated in patients with severe chronic heart failure compared to healthy volunteers?
Case-Control (n=63)
Are plasma endothelin concentrations elevated in patients with severe chronic heart failure compared to healthy volunteers?
Plasma endothelin concentrations are significantly elevated in patients with severe chronic heart failure, suggesting a potential pathophysiological role in the syndrome's characteristic vasoconstriction.
Answers are grounded in this paper and cite their sources.
May implicate endothelin in severe CHF vasoconstriction; hypothesis-generating and requires prospective validation before any clinical consideration.
BACKGROUND: Endothelins are recently characterized vasoconstrictor peptides. As chronic heart failure (CHF) is characterized by peripheral arteriolar and renal vasoconstriction, we have measured venous plasma endothelin-like immunoreactivity ("endothelin") in patients with this syndrome. METHODS AND RESULTS: Compared with age- and sex-matched healthy volunteers (mean +/- SEM plasma endothelin concentration 6.4 +/- 0.3 pmol/l, n = 16), patients with severe CHF had elevated peripheral venous endothelin concentrations (12.4 +/- 0.6 pmol/l, n = 47, p less than 0.01). Plasma endothelin did not increase with exercise in normal subjects or in patients. Plasma endothelin concentration (mean, 13.4 +/- 0.9 pmol/l) did not correlate with plasma atrial natriuretic factor concentration (mean, 88.9 +/- 11.9 pg/ml) in patients with CHF (n = 21). There was also no correlation between plasma endothelin and serum urea or between endothelin and serum creatinine in patients with CHF (n = 34). There was, however, significant renal extraction of endothelin (aorta, 11.1 +/- 0.8 pmol/l; renal vein, 8.8 +/- 0.6 pmol/ml; p = 0.02) in patients with CHF (n = 13). CONCLUSIONS: Evidence suggests that circulatory endothelin concentrations in the range 5-40 pmol/l are vasoactive. Consequently, the endothelin concentrations found in patients with CHF may be of pathophysiological significance.
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McMurray et al. (1992) conducted a case-control in Chronic heart failure (n=63). Severe chronic heart failure vs. Healthy volunteers was evaluated on Peripheral venous endothelin concentration (p=<0.01). Severe chronic heart failure was associated with elevated peripheral venous endothelin concentrations compared to healthy volunteers.
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