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February 2, 1997European Heart JournalOpen Access

Prognostic value of plasma endothelin-1 in patients with chronic heart failure

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Why the study?

Does elevated plasma endothelin-1 predict cardiac death in patients with chronic heart failure?

Population

120 congestive heart failure patients with ischaemic or non-ischaemic cardiomyopathy

Comparison

Plasma endothelin-1 levels measured by… vs Plasma endothelin-1 < 5 pg/ml vs >= 5 pg/ml

Design

Cohort

Follow-up

median 361 +/- 338 days

Authors

FPFrançoise PoussetRIRichard IsnardPLP Lechat

Discussion

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Overview

Supports endothelin-1 as a prognostic marker in chronic HF; leaves open its incremental value over standard risk models.

Key Points

  • To evaluate whether plasma concentrations of the vasoconstrictor peptide endothelin-1 serve as an independent prognostic biomarker of mortality in patients with chronic heart failure.
  • Measured plasma endothelin-1 levels using radioimmunoassay in 120 patients with chronic heart failure (mean ejection fraction 28 ± 11%; NYHA class I: 21, II: 35, III: 61, IV: 3).
  • Monitored patients over a median follow-up of 361 ± 338 days, recording 14 cardiac deaths.
  • Evaluated prognostic indicators using univariate and multivariate Cox proportional hazards models adjusting for atrial natriuretic peptide, noradrenaline, NYHA class, age, and left ventricular end-diastolic diameter index.
  • Endothelin-1 was the strongest univariate predictor of cardiac mortality (P = 0.0001) and the only variable that remained significantly predictive in the multivariate model (P = 0.02).
  • Patients with plasma endothelin-1 ≥ 5 pg/ml exhibited a significantly higher mortality rate than those with levels < 5 pg/ml (21% vs. 4%, P = 0.001).

Structured PICO

Does elevated plasma endothelin-1 predict cardiac death in patients with chronic heart failure?

P
Population
120 congestive heart failure patients with ischaemic or non-ischaemic cardiomyopathy (mean ejection fraction 28 +/- 11%, NYHA functional class I: 21, class II: 35, class III: 61, class IV: 3)
I
Intervention
Plasma endothelin-1 levels measured by radioimmunoassay
C
Comparator
Plasma endothelin-1 < 5 pg/ml vs >= 5 pg/ml
O
Outcome
Cardiac deathhard clinical

Elevated plasma endothelin-1 levels (>= 5 pg/ml) are independently associated with increased mortality in patients with mild to moderate chronic heart failure.

Cite This Study

Pousset et al. (1997) studied this question.

synapsesocial.com/papers/6a71631626a7f98052ddbfc2https://doi.org/10.1093/oxfordjournals.eurheartj.a015228
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