Elevation of plasmatic endothelin in patients with heart failure

Background. Endothelin I is an autocrine and paracrine factor with vasoconstrictive, mitogenic, and inotropic activities in vascular and cardiac muscles. Its elevation has been reported in patients with chronic heart failure and its production may be conditioned by activation of other neurohumoral factors that are stimulated by the disease. Methods. The objective of this study was to correlate level of endothelin (ET) with echocardiographic, clinical, and biochemical markers and to determine its role as an independent marker of severity. We included patients with congestive heart failure in whom echocardiographic evaluation had been done and serum markers measured. Serum endothelin I levels were determined by radioimmunoassay (RIA). Correlation between endothelin concentration, echocardiographic parameters, potentially confounding factors, and severity of heart failure was made. Results. Patients with symptomatic heart failure and longer time of evolution had higher levels of endothelin unrelated to levels of troponin T, tumor necrosis factor, and atrial natriuretic peptide. There were no differences in levels of endothelin, independently of the etiology of cardiac failure. Conclusions. These results support the idea that endothelin plays an important independent role in the physiopathology of heart failure. It may be a severity marker and an attractive therapeutic target. (C) 2003 IMSS. Published by Elsevier Inc.