Document Detail


Relationship between endothelin-1 extraction in the peripheral circulation and systemic vascular resistance in patients with severe congestive heart failure.
MedLine Citation:
PMID:  9973035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study was done to determine the spillover and extraction of endothelin-1 (ET-1) in the peripheral circulation, and to evaluate the factors that regulate local ET-1 extraction in the peripheral circulation in patients with congestive heart failure (CHF). BACKGROUND: The relationship between the spillover and extraction of the ET-1 in the peripheral circulation and systemic vascular resistance (SVR) has not been fully clarified. METHODS: We measured plasma levels of ET-1 both in femoral artery (FA) and femoral vein (FV) in 93 patients with CHF. RESULTS: Plasma ET-1 was significantly higher in FV than in FA in New York Heart Association (NYHA) functional class II patients, but there was no difference of ET-1 between FA and FV in functional class III patients. In patients with functional class IV, plasma ET-1 was significantly lower in FV than in FA, and SVR was significantly higher than in patients with NYHA class II or class III. Moreover, a significant positive correlation existed between plasma ET-1 extraction across the lower leg and SVR in these patients. Among the various neurohumoral factors and hemodynamics, plasma levels of ET-1, angiotensin II in the FA showed an independent and significant relationship with the plasma arteriovenous difference of ET-1 in the lower limb. CONCLUSIONS: Circulating ET-1 is extracted in peripheral circulation in patients with severe CHF, suggesting the possibility of upregulation of ET receptors of vascular beds in the lower limb in these patients. The peripheral extraction of ET-1 correlates with SVR in severe CHF patients and is mainly regulated by the local ET-1 and renin angiotensin systems.
Authors:
T Tsutamoto; A Wada; T Hisanaga; K Maeda; M Ohnishi; N Mabuchi; M Sawaki; M Hayashi; M Fujii; M Kinoshita
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  33     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-03-02     Completed Date:  1999-03-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  530-7     Citation Subset:  AIM; IM    
Affiliation:
First Department of Internal Medicine, Shiga University of Medical Science, Seta, Otsu, Japan. tutamoto@belle.shiga-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Angiotensin II / blood
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Atrial Natriuretic Factor / blood
Biological Markers / blood
Blood Pressure
Endothelin-1 / blood*
Female
Femoral Artery
Femoral Vein
Heart Failure / blood*,  drug therapy,  physiopathology
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Norepinephrine / blood
Pulmonary Wedge Pressure
Severity of Illness Index
Vascular Resistance*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Biological Markers; 0/Endothelin-1; 11128-99-7/Angiotensin II; 114471-18-0/Natriuretic Peptide, Brain; 51-41-2/Norepinephrine; 85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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