Key result
Plasma concentrations of angiotensin II and endothelin-1 were significantly correlated in patients with heart disease (r=0.72, P<0.0001), though the relationship may not be causal.
Why the study?
Does angiotensin II directly cause the elevated plasma endothelin concentrations observed in heart failure?
Observational (n=41)
Does angiotensin II directly cause the elevated plasma endothelin concentrations observed in heart failure?
Effect estimate: Spearman rank correlation coefficient 0.72
p-value: p=< 0.0001
Although angiotensin II and endothelin-1 levels are strongly correlated in heart failure, infusion studies suggest the relationship may not be directly causal.
Correlation in heart disease does not establish causality; leaves open whether angiotensin II directly drives endothelin-1 and warrants mechanistic trials.
Endothelin is a powerful vasoconstrictor that may be partly responsible for the increases in venous and arterial tone characteristic of heart failure. The release of endothelin from endothelial cells in culture is stimulated by angiotensin II. We investigated the relationship between plasma concentrations of immuno reactive endothelin-1 and angiotensin II in 25 patients with heart failure and eight with ischaemic heart disease but normal left ventricular function. Plasma concentrations of endothelin and angiotensin II were correlated (Spearman rank correlation coefficient of 0.72; P < 0.0001) in patients with heart disease. Plasma concentrations of angiotensin II and endothelin were higher in those patients with heart failure. Angiotensin II was infused over a 3 h period in eight healthy volunteers. Infusion of angiotensin II increased plasma concentrations of angiotensin II to levels greater than those usually found in patients with severe heart failure but induced only a modest rise in plasma concentrations of immunoreactive endothelin-1 (0.77 +/- 0.16 to 1.03 +/- 0.03 pmol.l-1, P < 0.02). Increased plasma concentrations of angiotensin II and endothelin-1 both appear to reflect the presence and severity of heart failure. Although a significant correlation exists between plasma concentrations of angiotensin II and endothelin in patients with heart failure, the relationship may not be causal.
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Good et al. (1994) conducted an observational in Heart failure and ischaemic heart disease (n=41). Angiotensin II was evaluated on Correlation between plasma concentrations of immunoreactive endothelin-1 and angiotensin II (Spearman rank correlation coefficient 0.72, p=< 0.0001). Plasma concentrations of angiotensin II and endothelin-1 were significantly correlated in patients with heart disease (r=0.72, P<0.0001), though the relationship may not be causal.
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