Document Detail

Clinical significance of endogenous vasoactive neurohormones in chronic systolic heart failure.
MedLine Citation:
PMID:  20670842     Owner:  NLM     Status:  In-Process    
BACKGROUND: Neurohormonal activation is a pathophysiological hallmark of acute and chronic heart failure (HF). The clinical significance of more recently discovered endogenous vasoactive hormones has not been well-characterized.
METHODS AND RESULTS: In 154 subjects with stable, chronic systolic HF (New York Heart Association Class I-IV, left ventricular [LV] ejection fraction <or=40%), we measured plasma levels of urocortin 1 (UCN-1), urotensin II (UT-II), and endothelin-1 (ET-1) and performed comprehensive echocardiography with assessment of cardiac structure and performance. Adverse clinical events (all-cause mortality, cardiac transplantation or HF hospitalization) were prospectively tracked for a median of 39 months. Plasma levels of UCN-1 and ET-1 (but not UT-II) increased with LV diastolic dysfunction stage, right ventricular systolic dysfunction class, and mitral regurgitation severity (P < .01 for all). Higher plasma levels of UCN-1 and ET-1 (but not UT-II) predicted increased risk for adverse clinical events. After adjustment for age, LV ejection fraction, and plasma amino-terminal pro-B-type natriuretic peptide, plasma UCN-1 >or=12.1 pM (HR: 2.02, 95% CI: 1.08-3.93, P = .029) and ET-1 >or=2.29 pM (HR: 2.52, 95% CI: 1.24-5.03, P = .011) remained significant independent risk factors for adverse clinical events.
CONCLUSION: Higher levels of plasma levels of UCN-1 and ET-1 but not UT-II were associated with worse LV diastolic performance and poorer long-term clinical outcomes in patients with chronic systolic HF.
W H Wilson Tang; Kevin Shrestha; Maureen G Martin; Allen G Borowski; Sue Jasper; Timothy G Yandle; A Mark Richards; Allan L Klein; Richard W Troughton
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-05-08
Journal Detail:
Title:  Journal of cardiac failure     Volume:  16     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
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