Plasma endothelin correlates with the extent of pulmonary hypertension in patients with chronic congestive heart failure.

Cody, Robert J.; Haas, Garrie J.; Binkley, Philip F.; Capers, Quinn; Kelley, Robin D. G.

doi:10.1161/01.cir.85.2.504

Cited by 577 publications

(245 citation statements)

References 14 publications

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“…ET levels are elevated in the plasma of patients with PH [42][43][44][45] and there is increased expression of ET-1 protein and mRNA in the endothelial cells of affected vessels in patients with PH [46]. In 21 patients with IPAH, elevated ET-1 levels correlated with right atrial pressure and pulmonary artery oxygen saturation [37].…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Biomarkers in pulmonary hypertension

Warwick

Thomas²,

Yates³

2008

European Respiratory Journal

136

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There have been significant recent advances in the understanding of the pathophysiology of pulmonary hypertension, and a growing number of therapeutic agents have become available to the treating physician. Traditional methods of diagnosing and monitoring this condition have comprised echocardiography and right heart catheterisation, in addition to functional measures, such as estimation of functional class and the 6-min walk test. An increasing number of biomarkers have been described that are elevated in pulmonary hypertension and which may assist the clinician in diagnosis and in the assessment of disease severity and response to treatment.The present article details the more important biomarkers, their potential applications and the evidence supporting their use.

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Section: Natriuretic Peptidesmentioning

confidence: 99%

Biomarkers in pulmonary hypertension

Warwick

Thomas²,

Yates³

2008

European Respiratory Journal

136

View full text Add to dashboard Cite

show abstract

“…Increase of the plasma concentration of ET-1(1-21) in heart failure correlates with the severity of heart failure, which has been reported to be useful in determining the prognosis (39,40). It was thought that rise of ET-1(1-21) concentrations in the organic damages of vascular endothelium reflects the degree of vascular disease and the associated with remodeling.…”

Section: Discussionmentioning

confidence: 99%

A novel peptide of endothelin family, 31 amino-acid length endothelin in patients with acute myocardial infarction

et al. 2014

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“…71 Abnormalities observed with other forms of PH have been demonstrated with PVH-PH (e.g., increased circulating endothelin-1 levels), but the meaning of this is unclear. For example, the fact that plasma endothelin-1 levels correlate with PAP in heart failure 72 does not establish a role for the peptide in the genesis of the PH. I will thus refrain from speculation regarding the usual PH molecular suspects, recognizing that some pathways that are relevant in other forms of PH will ultimately be shown to be involved in PVH-PH.…”

Section: Wall Stress and Pvh-phmentioning

confidence: 99%

Pulmonary Hypertension Caused by Pulmonary Venous Hypertension

Kulik

2014

Pulm. circ.

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The effect of pulmonary venous hypertension (PVH) on the pulmonary circulation is extraordinarily variable, ranging from no impact on pulmonary vascular resistance (PVR) to a marked increase. The reasons for this are unknown. Both acutely reversible pulmonary vasoconstriction and pathological remodeling (especially medial hypertrophy and intimal hyperplasia) account for increased PVR when present. The mechanisms involved in vasoconstriction and remodeling are not clearly defined, but increased wall stress, especially in small pulmonary arteries, presumably plays an important role. Myogenic contraction may account for increased vascular tone and also indirectly stimulate remodeling of the vessel wall. Increased wall stress may also directly cause smooth muscle growth, migration, and intimal hyperplasia. Even long-standing and severe pulmonary hypertension (PH) usually abates with elimination of PVH, but PVH-PH is an important clinical problem, especially because PVH due to left ventricular noncompliance lacks definitive therapy. The role of targeted PH therapy in patients with PVH-PH is unclear at this time. Most prospective studies indicate that these medications are not helpful or worse, but there is ample reason to think that a subset of patients with PVH-PH may benefit from phosphodiesterase inhibitors or other agents. A different approach to evaluating possible pharmacologic therapy for PVH-PH may be required to better define its possible utility.Keywords: pulmonary hypertension, pulmonary venous hypertension. As a perfect example of how clinical imperative can drive basic physiological investigation, studies of the effect of pulmonary venous hypertension (PVH) on the lung's circulation were in full swing by the very early 1950s, 1 close on the heels of the development of surgical relief of mitral valve stenosis. Cardiac catheterization of patients with mitral valve disease has characterized the physiology of PVH, and histological investigations demonstrated the microvascular changes provoked by PVH. Just as important, the effect of relief of left atrial (LA) hypertension on the circulation has been extensively reported, usually for patients who have had mitral valve intervention. We have learned that the circulatory alterations provoked by PVH share some characteristics with other forms of pulmonary hypertension (PH), such as the idiopathic variety, PH due to chronic alveolar hypoxia, and PH secondary to congenital cardiac shunting lesions. For example, acute "reactivity" to vasodilators may be observed, and there is overlap in the microarchitectural abnormalities seen. On the other hand, the "natural history" of PVH-PH is very different than that of the idiopathic variety or that seen with shunting defects: in the former (as demonstrated with mitral valve disease), PH is likely to largely or completely resolve if PVH is relieved, even with long-standing and severely increased pulmonary vascular resistance (PVR), 2,3 while in the latter two, PH is more likely to inexorably increase. PVH-PH is ther...

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Plasma endothelin correlates with the extent of pulmonary hypertension in patients with chronic congestive heart failure.

Abstract: Elevated immunoreactive endothelin-1 specifically correlated with the extent of pulmonary hypertension in congestive heart failure patients. Whether endothelin-1 is a regional mediator of pulmonary hypertension or a marker for its occurrence requires additional evaluation.

Cited by 577 publications

References 14 publications

Biomarkers in pulmonary hypertension

Biomarkers in pulmonary hypertension

A novel peptide of endothelin family, 31 amino-acid length endothelin in patients with acute myocardial infarction

Pulmonary Hypertension Caused by Pulmonary Venous Hypertension

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