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Circulation. 1994;89:1580-1586

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Circulation, Vol 89, 1580-1586, Copyright © 1994 by American Heart Association


ARTICLES

Endothelin in human congestive heart failure

CM Wei, A Lerman, RJ Rodeheffer, CG McGregor, RR Brandt, S Wright, DM Heublein, PC Kao, WD Edwards and JC Burnett Jr
Cardiorenal Research Laboratory, Mayo Clinic and Foundation, Rochester, MN 55905.

BACKGROUND: Although recent investigations report the elevation of plasma endothelin (ET) in congestive heart failure (CHF), it remains unclear if this elevation is that of the biologically active peptide ET- 1 or of its precursor big-ET. Furthermore, it is unclear if such elevation is associated with increased myocardial ET and if the molecular form from cardiac tissue is altered ET. Last, it remains to be established whether circulating ET is increased at the earliest stage of CHF in patients with asymptomatic left ventricular dysfunction and correlates with the magnitude of ventricular dysfunction. METHODS AND RESULTS: The present study was designed to investigate concentrations and molecular forms of ET in plasma and cardiac tissue in healthy subjects and CHF patients with New York Heart Association (NYHA) class I through IV using cardiac radionuclide angiogram, cardiac myocardial biopsy, radioimmunoassay, gel permeation chromatography (GPC), and immunohistochemical staining (IHCS). Plasma ET was increased only in patients with moderate (NYHA class III) or severe (NYHA class IV) CHF compared with healthy subjects and individuals with asymptomatic (NYHA class I) or mild (NYHA class II) CHF. The elevation of circulating ET in CHF showed a negative correlation with left ventricular ejection fraction and cardiac index and a positive correlation with functional class and left ventricular end-diastolic volume index. GPC demonstrated that immunoreactive plasma ET was ET-1 in healthy subjects and both mature ET-1 and its precursor big-ET in severe CHF patients, with big-ET the predominant molecular form. Cardiac tissue concentrations and IHCS revealed ET presence in healthy atrial and ventricular tissue, which were not different in severe CHF. GPC revealed that the molecular form of cardiac ET was ET-1 in both healthy and CHF hearts. CONCLUSIONS: The present study establishes for the first time that the elevation of plasma ET in severe human CHF represents principally elevation of big-ET. Second, ET is present in healthy and failing myocardia, and its activity by both immunohistochemistry and radioimmunoassay is not changed in CHF. Furthermore, the elevated plasma ET is characteristic of severe CHF and not asymptomatic or mild CHF. In addition, the degree of plasma elevation of ET correlates with the magnitude of alterations in cardiac hemodynamics and functional class. The present study confirms and extends previous investigations of ET in human CHF and establishes the evolution of circulating and local cardiac ET in the spectrum of human CHF.


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Nephrol. Dial. Transplant., June 1, 2000; 15(6): 758 - 760.
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J. Pharmacol. Exp. Ther.Home page
M. J. Clair, M. K. King, A. T. Goldberg, J. W. Hendrick, R. Nisato, D. M. Gay, A. E. Morrison, J. H. McElmurray III, R. S. Krombach, B. R. Bond, et al.
Selective Vasopressin, Angiotensin II, or Dual Receptor Blockade with Developing Congestive Heart Failure
J. Pharmacol. Exp. Ther., June 1, 2000; 293(3): 852 - 860.
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Am. J. Physiol. Heart Circ. Physiol.Home page
A. Ergul, C. A. Walker, A. Goldberg, S. C. Baicu, J. W. Hendrick, M. K. King, and F. G. Spinale
ET-1 in the myocardial interstitium: relation to myocyte ECE activity and expression
Am J Physiol Heart Circ Physiol, June 1, 2000; 278(6): H2050 - H2056.
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Am. J. Physiol. Heart Circ. Physiol.Home page
H. Kjekshus, O. A. Smiseth, R. Klinge, E. Oie, M. E. Hystad, and H. Attramadal
Regulation of ET: pulmonary release of ET contributes to increased plasma ET levels and vasoconstriction in CHF
Am J Physiol Heart Circ Physiol, April 1, 2000; 278(4): H1299 - H1310.
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Circ. Res.Home page
G. G. N. Serneri, I. Cecioni, S. Vanni, R. Paniccia, B. Bandinelli, A. Vetere, X. Janming, I. Bertolozzi, M. Boddi, G. F. Lisi, et al.
Selective Upregulation of Cardiac Endothelin System in Patients With Ischemic but Not Idiopathic Dilated Cardiomyopathy : Endothelin-1 System in the Human Failing Heart
Circ. Res., March 3, 2000; 86(4): 377 - 385.
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Am. J. Physiol. Heart Circ. Physiol.Home page
M. T. Rademaker, V. A. Cameron, C. J. Charles, E. A. Espiner, M. G. Nicholls, C. J. Pemberton, and A. M. Richards
Neurohormones in an ovine model of compensated postinfarction left ventricular dysfunction
Am J Physiol Heart Circ Physiol, March 1, 2000; 278(3): H731 - H740.
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CirculationHome page
P. A. MacCarthy, R. Grocott-Mason, B. D. Prendergast, and A. M. Shah
Contrasting Inotropic Effects of Endogenous Endothelin in the Normal and Failing Human Heart : Studies With an Intracoronary ETA Receptor Antagonist
Circulation, January 18, 2000; 101(2): 142 - 147.
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J Am Coll CardiolHome page
T. Mishima, M. Tanimura, G. Suzuki, A. Todor, V. G. Sharov, S. Goldstein, and H. N. Sabbah
Effects of long-term therapy with bosentan on the progression of left ventricular dysfunction and remodeling in dogs with heart failure
J. Am. Coll. Cardiol., January 1, 2000; 35(1): 222 - 229.
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Am. J. Physiol. Heart Circ. Physiol.Home page
C. E. Negrao, M. A. Hamilton, G. C. Fonarow, A. Hage, J. D. Moriguchi, and H. R. Middlekauff
Impaired endothelium-mediated vasodilation is not the principal cause of vasoconstriction in heart failure
Am J Physiol Heart Circ Physiol, January 1, 2000; 278(1): H168 - H174.
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Am. J. Physiol. Heart Circ. Physiol.Home page
C. Wei and J. C. Burnett Jr.
Inhibition by calcium antagonism of circulating and renal endothelin in experimental congestive heart failure
Am J Physiol Heart Circ Physiol, January 1, 2000; 278(1): H263 - H268.
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CirculationHome page
K. Ono, A. Matsumori, T. Shioi, Y. Furukawa, and S. Sasayama
Contribution of Endothelin-1 to Myocardial Injury in a Murine Model of Myocarditis : Acute Effects of Bosentan, an Endothelin Receptor Antagonist
Circulation, October 26, 1999; 100(17): 1823 - 1829.
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Hum ReprodHome page
R. Bajoria, M. Sullivan, and N. M. Fisk
Endothelin concentrations in monochorionic twins with severe twin–twin transfusion syndrome
Hum. Reprod., June 1, 1999; 14(6): 1614 - 1618.
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HypertensionHome page
L. Tiret, O. Poirier, V. Hallet, T. A. McDonagh, C. Morrison, J. J. V. McMurray, H. J. Dargie, D. Arveiler, J.-B. Ruidavets, G. Luc, et al.
The Lys198Asn Polymorphism in the Endothelin-1 Gene Is Associated With Blood Pressure in Overweight People
Hypertension, May 1, 1999; 33(5): 1169 - 1174.
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CirculationHome page
O. Zolk, J. Quattek, G. Sitzler, T. Schrader, G. Nickenig, P. Schnabel, K. Shimada, M. Takahashi, and M. Bohm
Expression of Endothelin-1, Endothelin-Converting Enzyme, and Endothelin Receptors in Chronic Heart Failure
Circulation, April 27, 1999; 99(16): 2118 - 2123.
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CirculationHome page
B. Pieske, B. Beyermann, V. Breu, B. M. Loffler, K. Schlotthauer, L. S. Maier, S. Schmidt-Schweda, H. Just, and G. Hasenfuss
Functional Effects of Endothelin and Regulation of Endothelin Receptors in Isolated Human Nonfailing and Failing Myocardium
Circulation, April 13, 1999; 99(14): 1802 - 1809.
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J. Pharmacol. Exp. Ther.Home page
J. D. Parker, J. J. Thiessen, R. Reilly, J. H. Tong, D. J. Stewart, and A. S. Pandey
Human Endothelin-1 Clearance Kinetics Revealed by a Radiotracer Technique
J. Pharmacol. Exp. Ther., April 1, 1999; 289(1): 261 - 265.
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J Am Coll CardiolHome page
P. J. Cowburn, J. G. F. Cleland, J. D. McArthur, M. R. MacLean, J. J. V. McMurray, H. J. Dargie, and J. J. Morton
EndothelinB receptors are functionally important in mediating vasoconstriction in the systemic circulation in patients with left ventricular systolic dysfunction
J. Am. Coll. Cardiol., March 15, 1999; 33(4): 932 - 938.
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J. Pharmacol. Exp. Ther.Home page
K. Onishi, M. Ohno, W. C. Little, and C.-P. Cheng
Endogenous Endothelin-1 Depresses Left Ventricular Systolic and Diastolic Performance in Congestive Heart Failure
J. Pharmacol. Exp. Ther., March 1, 1999; 288(3): 1214 - 1222.
[Abstract] [Full Text]


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J Am Coll CardiolHome page
T. Inada, H. Fujiwara, K. Hasegawa, M. Araki, R. Yamauchi-Kohno, H. Yabana, T. Fujiwara, M. Tanaka, and S. Sasayama
Upregulated expression of cardiac endothelin-1 participates in myocardial cell growth in Bio14.6 Syrian cardiomyopathic hamsters
J. Am. Coll. Cardiol., February 1, 1999; 33(2): 565 - 571.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. Kaburagi, K. Hasegawa, T. Morimoto, M. Araki, T. Sawamura, T. Masaki, and S. Sasayama
The Role of Endothelin-Converting Enzyme-1 in the Development of {alpha}1-Adrenergic-Stimulated Hypertrophy in Cultured Neonatal Rat Cardiac Myocytes
Circulation, January 19, 1999; 99(2): 292 - 298.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
I. Anwaar, A. Gottsater, F. Lindgarde, and I. Mattiasson
Increasing Plasma Neopterin and Persistent Plasma Endothelin During Follow-up After Acute Cerebral Ischemia
Angiology, January 1, 1999; 50(1): 1 - 8.
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CirculationHome page
G. Sutsch, W. Kiowski, X.-W. Yan, P. Hunziker, S. Christen, W. Strobel, J.-H. Kim, P. Rickenbacher, and O. Bertel
Short-Term Oral Endothelin-Receptor Antagonist Therapy in Conventionally Treated Patients With Symptomatic Severe Chronic Heart Failure
Circulation, November 24, 1998; 98(21): 2262 - 2268.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
M. Hulsmann, B. Stanek, B. Frey, B. Sturm, D. Putz, T. Kos, R. Berger, W. Woloszczuk, G. Maurer, and R. Pacher
Value of cardiopulmonary exercise testing and big endothelin plasma levels to predict short-term prognosis of patients with chronic heart failure
J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1695 - 1700.
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J Am Coll CardiolHome page
K. Alexiou, T. Dschietzig, O. Simsch, M. Laule, J. Hundertmark, G. Baumann, and K. Stangl
Arrhythmogenic effects induced by coronary conversion of pulmonary big endothelin to endothelin: Aggravation of this phenomenon in heritable hyperlipidemia
J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1773 - 1778.
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J Am Coll CardiolHome page
D. Saad, R. Mukherjee, P. B. Thomas, J. P. Iannini, C. G. Basler, L. Hebbar, S.-J. O, S. Moreland, M. L. Webb, J. R. Powell, et al.
The effects of endothelin-A receptor blockade during the progression of pacing-induced congestive heart failure
J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1779 - 1786.
[Abstract] [Full Text] [PDF]


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CirculationHome page
Y. Iwanaga, Y. Kihara, K. Hasegawa, K. Inagaki, T. Yoneda, S. Kaburagi, M. Araki, and S. Sasayama
Cardiac Endothelin-1 Plays a Critical Role in the Functional Deterioration of Left Ventricles During the Transition From Compensatory Hypertrophy to Congestive Heart Failure in Salt-Sensitive Hypertensive Rats
Circulation, November 10, 1998; 98(19): 2065 - 2073.
[Abstract] [Full Text] [PDF]


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CirculationHome page
F. G. Spinale, R. Mukherjee, R. S. Krombach, M. J. Clair, J. W. Hendrick, W. V. Houck, L. Hebbar, S. B. Kribbs, J. L. Zellner, and M. G. Dodd
Chronic Amlodipine Treatment During the Development of Heart Failure
Circulation, October 20, 1998; 98(16): 1666 - 1674.
[Abstract] [Full Text] [PDF]


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CirculationHome page
J. Dupuis, J.-L. Rouleau, and P. Cernacek
Reduced Pulmonary Clearance of Endothelin-1 Contributes to the Increase of Circulating Levels in Heart Failure Secondary to Myocardial Infarction
Circulation, October 20, 1998; 98(16): 1684 - 1687.
[Abstract] [Full Text] [PDF]


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VASC ENDOVASCULAR SURGHome page
B. W. Mays, T. Ripple, M. T. Eginton, G. R. Seabrook, R. A. Cambria, J. B. Towne, and J. A. Freischlag
Smoking Cessation Reverses Arterial Endothelium-Dependent Relaxation Injury
Vascular and Endovascular Surgery, September 1, 1998; 32(5): 407 - 413.
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Cardiovasc ResHome page
P. J. Cowburn, J. G.F. Cleland, J. D. McArthur, M. R. MacLean, H. J. Dargie, J. J.V. McMurray, and J. J. Morton
Endothelin-1 has haemodynamic effects at pathophysiological concentrations in patients with left ventricular dysfunction
Cardiovasc Res, September 1, 1998; 39(3): 563 - 570.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
G. W Moe, A. Albernaz, G. O Naik, M. Kirchengast, and D. J Stewart
Beneficial effects of long-term selective endothelin type A receptor blockade in canine experimental heart failure
Cardiovasc Res, September 1, 1998; 39(3): 571 - 579.
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Cardiovasc ResHome page
R. Choussat, L. Hittinger, F. Barbe, G. Maistre, A. Carayon, B. Crozatier, and J. Su
Acute effects of an endothelin-1 receptor antagonist bosentan at different stages of heart failure in conscious dogs
Cardiovasc Res, September 1, 1998; 39(3): 580 - 588.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
M. Suzuki, N. Ohte, Z.-M. Wang, D. L. Williams Jr., W. C. Little, and C.-P. Cheng
Altered inotropic response of endothelin-1 in cardiomyocytes from rats with isoproterenol-induced cardiomyopathy
Cardiovasc Res, September 1, 1998; 39(3): 589 - 599.
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Cardiovasc ResHome page
P. Mulder, V. Richard, F. Bouchart, G. Derumeaux, K. Munter, and C. Thuillez
Selective ETA receptor blockade prevents left ventricular remodeling and deterioration of cardiac function in experimental heart failure
Cardiovasc Res, September 1, 1998; 39(3): 600 - 608.
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HeartHome page
S M Maguire, A G Nugent, C McGurk, G D Johnston, and D P Nicholls
Abnormal vascular responses in human chronic cardiac failure are both endothelium dependent and endothelium independent
Heart, August 1, 1998; 80(2): 141 - 145.
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Cardiovasc ResHome page
R.S. Krombach, M. J Clair, J. W Hendrick, W. V Houck, J. L Zellner, S. B Kribbs, S. Whitebread, R. Mukherjee, M. de Gasparo, and F. G Spinale
Angiotensin converting enzyme inhibition, AT1 receptor inhibition, and combination therapy with pacing induced heart failure: effects on left ventricular performance and regional blood flow patterns
Cardiovasc Res, June 1, 1998; 38(3): 631 - 645.
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CirculationHome page
B. Bozkurt, S. B. Kribbs, F. J. Clubb Jr, L. H. Michael, V. V. Didenko, P. J. Hornsby, Y. Seta, H. Oral, F. G. Spinale, and D. L. Mann
Pathophysiologically Relevant Concentrations of Tumor Necrosis Factor-{alpha} Promote Progressive Left Ventricular Dysfunction and Remodeling in Rats
Circulation, April 14, 1998; 97(14): 1382 - 1391.
[Abstract] [Full Text] [PDF]