Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients

Frey, Bernhard; Pacher, Richard; Locker, Gottfried J.; Bojic, Anda; Hartter, Engelbert; Woloszczuk, W.; Stanek, Brigitte

doi:10.1378/chest.117.6.1713

Cited by 20 publications

(13 citation statements)

References 25 publications

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“…[7][8][9] Furthermore, studies have shown the value of sequential measurement of big ET-1 concentration in therapeutic monitoring, with the change in concentration predicting the magnitude of therapeutic response and future outcome. 10,11,33,34 Unfortunately, a significant limitation to the clinical application of neurohormone measurement in veterinary medicine is the lack of commercially available assays for rapid and easy determination of most neurohormones. It is hoped that this will change as more data become available regarding the utility of this information.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of circulating neurohormones activated in the setting of DCM has the potential to contribute favorably to these issues. Studies in symptomatic and asymptomatic human DCM patients have found increases in markers of the sympathetic nervous system (SNS) (ie, norepinephrine, arginine vasopressin), 1,2 the renin-angiotensin-aldosterone system (RAAS) (ie, renin, angiotensin, aldosterone, hyponatremia), 3 the natriuretic peptides (ie, atrial and brain natriuretic peptides), [4][5][6] and the endothelin (ET) system (ie, ET-1, big ET-1), [7][8][9][10][11] and this data has proven useful to assess prognosis and therapeutic response, serving as a rationale for investigation of these same neurohormones in dogs with DCM.…”

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confidence: 99%

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Plasma Big Endothelin‐1, Atrial Natriuretic Peptide, Aldosterone, and Norepinephrine Concentrations in Normal Doberman Pinschers and Doberman Pinschers with Dilated Cardiomyopathy

O’Sullivan

O'Grady

Minors

2007

Veterinary Internal Medicne

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Background: Dilated cardiomyopathy (DCM) results in progressive myocardial and circulatory dysfunction causing activation of a number of neurohormonal systems, including the endothelin (ET) system, which is only beginning to be described in clinical veterinary medicine. Measurement of these circulating neurohormones possesses potential utility in the diagnosis, staging, and assessment of prognosis in cardiac disease.Hypothesis: We hypothesized that plasma big ET-1, norepinephrine (NE), aldosterone, and atrial natriuretic peptide (ANP) concentrations in normal Dobermans would differ from those in Dobermans with DCM, and that concentrations of these hormones would be associated with time to congestive heart failure (CHF) or death.Animals: Thirty client-owned Dobermans (10 each of normal, occult DCM, and overt DCM) were included in the study. .7], P 5 .011). Dogs with overt DCM had significantly higher concentrations of all neurohormones compared with the normal group. Furthermore, increasing big ET-1 (risk ratio [RR] 2.7, CI 1.3-8.6, P 5.01) and NE concentrations (RR 3.9, CI 1.1-18.1, P 5.03) over 1 month were associated with a shorter survival time.Conclusions and Clinical Importance: High ANP concentrations can identify dogs with advanced occult DCM. Increasing big ET-1 or NE concentrations over time can be useful predictors of poor prognosis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Plasma Big Endothelin‐1, Atrial Natriuretic Peptide, Aldosterone, and Norepinephrine Concentrations in Normal Doberman Pinschers and Doberman Pinschers with Dilated Cardiomyopathy

O’Sullivan

O'Grady

Minors

2007

Veterinary Internal Medicne

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“…In CHF patients, big ET1 is used primarily as a prognostic marker [15,[22][23][24][25]. Natriuretic peptides have been widely used in the evaluation of diagnosis and prognosis in patients with CHF; hence, they are also of value in long term CHF management.…”

Section: Current Clinical Applications Of Big Et1 and Bnp In Patientsmentioning

confidence: 99%

The value of B‐type natriuretic peptide and big endothelin‐1 for detection of severe pulmonary hypertension in heart transplant candidates

Kubánek

Málek

Kautzner

et al. 2005

European J of Heart Fail

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Background: Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B-type natriuretic peptide (BNP) and big endothelin-1 (big ET1) for prediction of severe PH in heart transplant candidates. Methods: The study population included 43 potential heart transplant candidates (38 males, mean age 52F7 years). All underwent repeated right-heart catheterizations (2-5 studies) at an interval of 3-4 months, giving a total of 124 examinations, associated with blood sampling for BNP and big ET1 analysis. Severe PH was defined as the mean pulmonary artery pressure (MPAP)N40 mmHg. Results: Significantly high PVR (PVRN3.0 Wood units and TPGN15 mmHg) was noted on 12 occasions in 10 patients; always in the presence of severe PH. Low BNP levels (b67 pg/ml) ruled out the presence of severe PH with a 100% sensitivity, however, with a low specificity (34%). An increase in plasma BNPN30 pg/ml (N40% of initial value) in subjects with a previous MPAPV40 mmHg detected development of severe PH with a 100% sensitivity and an 80-88% specificity. As a total of 58% of patients presented repeatedly with MPAPV40mmHg, serial BNP testing could reduce the need for hemodynamic studies in this subgroup down to 12-20%. Conclusions: Serial BNP testing in hemodynamically stable heart transplant candidates with MPAPV40 mmHg allows reliable detection of development of severe PH, and may significantly reduce the need for repeated right-heart catheterizations in these patients.

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“…Die wichtige Rolle der metabolischen/ endokrinen Funktion der Lunge kann am Beispiel der Endotheline demonstriert werden, einer Klasse vaskonstriktorischer Peptide, die in der Pathophysiologie des CHF und der damit assoziierten Nierenfunktionsstörung eine wichtige Rolle spielen [16]. Im Lungenversagen wird die Lunge von einem endothelinextrahierenden zu einem endothelinproduzierenden Organ [17].…”

Section: Lungeunclassified

Nierenversagen bei Herzinsuffizienz und Hypervolämie

Druml¹

2014

Wien klin Mag

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Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients

Cited by 20 publications

References 25 publications

Plasma Big Endothelin‐1, Atrial Natriuretic Peptide, Aldosterone, and Norepinephrine Concentrations in Normal Doberman Pinschers and Doberman Pinschers with Dilated Cardiomyopathy

Plasma Big Endothelin‐1, Atrial Natriuretic Peptide, Aldosterone, and Norepinephrine Concentrations in Normal Doberman Pinschers and Doberman Pinschers with Dilated Cardiomyopathy

The value of B‐type natriuretic peptide and big endothelin‐1 for detection of severe pulmonary hypertension in heart transplant candidates

Nierenversagen bei Herzinsuffizienz und Hypervolämie

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