| Neurohormonal markers of clinical outcome in cardiovascular disease: is endothelin the best one? | |
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MedLine Citation:
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PMID: 9736439 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Endothelin-1 (ET-1) is the most potent vasoconstrictor yet described. The active 21-amino-acid peptide is derived from the conversion of the inactive precursor "Big ET-1" by an enzyme called endothelin-converting enzyme. In addition to its potent action as a vasoconstrictor, endothelin promotes growth and proliferation of smooth muscle and myocardial hypertrophy. ET-1 levels are elevated in acute myocardial infarction (MI), atherosclerosis, renal failure, diabetes, pulmonary hypertension, and congestive heart failure (CHF). ET-1 levels correlate extremely well with the seriousness of the pathophysiologic condition. ET-1 levels at 72 h post MI accurately predict long-term survival. In patients with heart failure, ET-1 levels also predict long-term outcome, with the prognosis being severely compromised in patients with elevated ET-1 levels. Levels of plasma big ET-1 have been demonstrated to predict 1-year mortality and have been shown to be a better predictor of 1-year outcome than plasma atrial natriuretic peptide and norepinephrine, NYHA class, age, and echocardiographic left ventricular parameters. Although a small number of studies have reported beneficial effects of ACE inhibitors on ET-1 levels in animal models, most reports in humans have not found an effect of ACE inhibitors on ET-1 levels. Only one ACE inhibitor, fosinopril, has been shown to be effective in normalizing ET-1 levels in clinically relevant situations, such as the long-term study of patients with CHF. This observation may point to a superior role of fosinopril compared with other ACE inhibitors in CHF patients and may indicate beneficial effects of fosinopril beyond blood pressure control. |
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Authors:
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J C Monge |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of cardiovascular pharmacology Volume: 32 Suppl 2 ISSN: 0160-2446 ISO Abbreviation: J. Cardiovasc. Pharmacol. Publication Date: 1998 |
Date Detail:
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Created Date: 1998-11-17 Completed Date: 1998-11-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7902492 Medline TA: J Cardiovasc Pharmacol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: S36-42 Citation Subset: IM |
Affiliation:
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St. Michael's Hospital and University of Toronto, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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pharmacology Biological Markers Cardiovascular Diseases / blood*, drug therapy Endothelin-1 / blood* Heart Failure / blood, drug therapy Humans Prognosis Receptors, Endothelin / analysis |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Biological Markers; 0/Endothelin-1; 0/Receptors, Endothelin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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