Circulation, Vol 89, 1573-1579, Copyright © 1994 by American Heart Association
T Omland, RT Lie, A Aakvaag, T Aarsland and K Dickstein
BACKGROUND: Plasma endothelin concentrations are increased in the acute
phase of myocardial infarction and in chronic heart failure. Since
endothelin may contribute to hemodynamic deterioration by potent
vasoconstrictory and cardiotoxic actions, increased plasma levels may be
associated with an unfavorable prognosis after myocardial infarction.
METHODS AND RESULTS: We tested the hypothesis that plasma endothelin
determination in the subacute phase of myocardial infarction is related to
subsequent survival and assessed whether plasma endothelin measurements
provide additional prognostic information to that obtained from clinical
and biochemical variables previously known to be associated with high
mortality. Plasma endothelin determination was obtained from 142 patients
(average age +/- SD, 67.8 +/- 10.1 years) on day 3 after documented
myocardial infarction and was related to 1-year mortality. Sixteen patients
died during the follow-up period. In a univariate Cox proportional-hazards
model, day 3 plasma endothelin concentrations were significantly related to
mortality (P < .0001). Patient age, previous treatment for systemic
hypertension, presence of clinical heart failure, and plasma atrial
natriuretic factor levels were all related to mortality in univariate
analysis but provided no additional prognostic information to that obtained
from endothelin determination in a multivariate model. CONCLUSIONS: Plasma
endothelin concentrations are strongly related to outcome after myocardial
infarction and provide prognostic information independent of clinical and
biochemical variables previously associated with a poor prognosis.
ARTICLES
Plasma endothelin determination as a prognostic indicator of 1-year mortality after acute myocardial infarction
Medical Department, Central Hospital in Rogaland, Stavanger, Norway.
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J. Pernow and Q.-D. Wang Endothelin in myocardial ischaemia and reperfusion Cardiovasc Res, March 1, 1997; 33(3): 518 - 526. [Abstract] [PDF]
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T. Tonnessen, G. Christensen, E. Oie, E. Holt, H. Kjekshus, O. A. Smiseth, O. M. Sejersted, and H. Attramadal Increased cardiac expression of endothelin-1 mRNA in ischemic heart failure in rats Cardiovasc Res, March 1, 1997; 33(3): 601 - 610. [Abstract] [PDF]
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P.M. Piatti, L.D. Monti, G. Valsecchi, M. Conti, R. Nasser, B. Guazzini, E. Fochesato, C.V. Phan, A.E. Pontiroli, and G. Pozza Effects of Low-Dose Heparin Infusion on Arterial Endothelin-1 Release in Humans Circulation, December 1, 1996; 94(11): 2703 - 2707. [Abstract] [Full Text]
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R. R. Wenzel, N. Duthiers, G. Noll, J. Bucher, U. Kaufmann, and T. F. Luscher Endothelin and Calcium Antagonists in the Skin Microcirculation of Patients With Coronary Artery Disease Circulation, August 1, 1996; 94(3): 316 - 322. [Abstract] [Full Text]
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M. M.H. Marijianowski, M. van Laar, J. Bras, and A. E. Becker Chronic Congestive Heart Failure Is Associated With a Phenotypic Shift of Intramyocardial Endothelial Cells Circulation, September 15, 1995; 92(6): 1494 - 1498. [Abstract] [Full Text]
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