| Superiority of big endothelin-1 and endothelin-1 over natriuretic peptides in predicting survival in severe congestive heart failure: a 7-year follow-up study. | |
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MedLine Citation:
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PMID: 15599839 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Plasma concentrations of atrial and brain natriuretic peptides (ANP, BNP), of their N-terminal pro-peptides, of endothelin-1 (ET-1), and big endothelin-1 (big ET-1) have diagnostic and prognostic significance in congestive heart failure (CHF). However, their respective values as a predictor of survival remain controversial and have never been directly compared in severe CHF. METHODS AND RESULTS: We analyzed, in 47 patients with severe CHF (New York Heart Association [NYHA] class III to IV; age 66 +/- 8 years, ejection fraction 20 +/- 6%), the prognostic performance of a panel of neurohormones and assays (N-terminal pro-ANP 1-25, 68-98 by radioimmunoassay [RIA], and 1-98 by enzyme-linked immunosorbent assay [ELISA], BNP by RIA and immunoradiometric assay [IRMA], N-terminal pro-BNP by Elisa, ET-1 by RIA, and big ET-1 by RIA and Elisa. Data were compared with 40 patients with mild to moderate CHF [NYHA I-II] and 30 healthy subjects. After a follow-up of 81 +/- 15 months, there were 34 deaths and 1 heart transplant. All neurohormones were significantly higher at baseline in patients with severe than in mild to moderate CHF or healthy subjects (all P < .001). Although all neurohormones but BNP IRMA were significant predictors of survival in univariate analysis, only big ET-1 RIA and ET-1 were independent predictors of survival (improvement chi(2): 7.5 and 4.6, P < .01 and P < .05). Using medians as cutpoints of big ET-1 RIA and ET-1, 2 severe CHF populations were defined with a different outcome (5-year survival: 55 versus 18%, P < .01). CONCLUSIONS: Big ET-1 and ET-1 are strong independent predictors of survival in patients with severe CHF and better for this purpose than natriuretic peptides or their pro-peptides. These markers allow easily to identify a population with a very high risk mortality eligible for more aggressive therapies. |
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Authors:
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Ronald Van Beneden; Olivier Gurné; Philippe L Selvais; Sylvie A Ahn; Annie R Robert; Jean-Marie Ketelslegers; Hubert G Pouleur; Michel F Rousseau |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiac failure Volume: 10 ISSN: 1071-9164 ISO Abbreviation: J. Card. Fail. Publication Date: 2004 Dec |
Date Detail:
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Created Date: 2004-12-15 Completed Date: 2005-04-07 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
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Languages: eng Pagination: 490-5 Citation Subset: IM |
Affiliation:
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Diabetes and Nutrition Unit, Division of Cardiology, School of Public Health, University of Louvain, B-1200 Brussels, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Natriuretic Factor
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blood* Endothelin-1 / blood* Female Heart Failure / blood*, mortality* Humans Immunoradiometric Assay Male Middle Aged Natriuretic Peptide, Brain / blood* Prognosis |
| Chemical | |
Reg. No./Substance:
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0/Endothelin-1; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor |
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