Ray S G, McMurray J J, Morton J J, Dargie H J
Department of Cardiology, Western Infirmary, Glasgow, UK.
Br Heart J. 1992 May;67(5):383-6. doi: 10.1136/hrt.67.5.383.
Endothelin is an extremely potent vasoconstrictor that may have a role in the pathogenesis of acute myocardial ischaemia. Atrial natriuretic factor is an endogenous antagonist of endothelin. To find the pattern and possible importance of circulating endothelin in ischaemic heart disease, concentrations in normal controls and those in patients with stable and unstable angina, acute myocardial infarction, and chronic cardiac failure were compared. The relation between circulating concentrations of endothelin and atrial natriuretic factor in the aftermath of myocardial infarction was also examined.
Eighteen patients with acute myocardial infarction, 10 with unstable angina, 10 with stable angina, 12 with chronic cardiac failure, and 10 normal controls were studied. Endothelin concentration was measured in venous plasma by radioimmunoassay. In patients with acute myocardial infarction simultaneous concentrations of endothelin and atrial natriuretic factor were measured on admission and at one, four, and 24 hours.
Mean concentrations (SEM) of endothelin were 5.72 (0.19) fmol/ml in controls, 6.56 (0.48) fmol/ml in stable angina, 6.41 (0.48) fmol/ml in unstable angina, and 13.83 (0.95) fmol/ml in chronic cardiac failure. In acute myocardial infarction concentrations were 8.81 (0.69) fmol/ml on admission, 11.85 (1.02) fmol/ml at one hour, 11.88 (1.10) fmol/ml at four hours, and 7.30 (0.49) fmol/ml at 24 hours. Concentrations of atrial natriuretic factor at the same times were 68.1 (13.1) pg/ml, 8.4 (1.5) pg/ml, 24.4 (4.1) pg/ml, and 42.0 (6.9) pg/ml.
Plasma endothelin is raised in chronic heart failure and in the aftermath of acute myocardial infarction but not in stable or unstable angina. After myocardial infarction endothelin concentrations are raised whereas concentrations of atrial natriuretic factor are relatively low. The role of endothelin in the pathogenesis of acute myocardial infarction and its interactions with other humoral factors require further investigation.
内皮素是一种极强的血管收缩剂，可能在急性心肌缺血的发病机制中起作用。心钠素是内皮素的内源性拮抗剂。为了找出缺血性心脏病患者循环内皮素的模式及其可能的重要性，对正常对照组以及稳定型和不稳定型心绞痛、急性心肌梗死和慢性心力衰竭患者的内皮素浓度进行了比较。还研究了心肌梗死后循环内皮素浓度与心钠素之间的关系。
研究了18例急性心肌梗死患者、10例不稳定型心绞痛患者、10例稳定型心绞痛患者、12例慢性心力衰竭患者和10例正常对照者。采用放射免疫分析法测定静脉血浆中的内皮素浓度。对急性心肌梗死患者，在入院时及1小时、4小时和24小时同时测定内皮素和心钠素的浓度。
对照组内皮素的平均浓度（标准误）为5.72（0.19）fmol/ml，稳定型心绞痛患者为6.56（0.48）fmol/ml，不稳定型心绞痛患者为6.41（0.48）fmol/ml，慢性心力衰竭患者为13.83（0.95）fmol/ml。急性心肌梗死患者入院时浓度为8.81（0.69）fmol/ml，1小时时为11.85（1.02）fmol/ml，4小时时为11.88（1.10）fmol/ml，24小时时为7.30（0.49）fmol/ml。同一时间的心钠素浓度分别为68.1（13.1）pg/ml、8.4（1.5）pg/ml、24.4（4.1）pg/ml和42.0（6.9）pg/ml。
慢性心力衰竭和急性心肌梗死后血浆内皮素升高，但稳定型或不稳定型心绞痛患者血浆内皮素不升高。心肌梗死后内皮素浓度升高，而心钠素浓度相对较低。内皮素在急性心肌梗死发病机制中的作用及其与其他体液因子的相互作用需要进一步研究。
