McMurray J J, Ray S G, Abdullah I, Dargie H J, Morton J J
Department of Cardiology, Western Infirmary, Glasgow, UK.
Circulation. 1992 Apr;85(4):1374-9. doi: 10.1161/01.cir.85.4.1374.
Endothelins are recently characterized vasoconstrictor peptides. As chronic heart failure (CHF) is characterized by peripheral arteriolar and renal vasoconstriction, we have measured venous plasma endothelin-like immunoreactivity ("endothelin") in patients with this syndrome.
Compared with age- and sex-matched healthy volunteers (mean +/- SEM plasma endothelin concentration 6.4 +/- 0.3 pmol/l, n = 16), patients with severe CHF had elevated peripheral venous endothelin concentrations (12.4 +/- 0.6 pmol/l, n = 47, p less than 0.01). Plasma endothelin did not increase with exercise in normal subjects or in patients. Plasma endothelin concentration (mean, 13.4 +/- 0.9 pmol/l) did not correlate with plasma atrial natriuretic factor concentration (mean, 88.9 +/- 11.9 pg/ml) in patients with CHF (n = 21). There was also no correlation between plasma endothelin and serum urea or between endothelin and serum creatinine in patients with CHF (n = 34). There was, however, significant renal extraction of endothelin (aorta, 11.1 +/- 0.8 pmol/l; renal vein, 8.8 +/- 0.6 pmol/ml; p = 0.02) in patients with CHF (n = 13).
Evidence suggests that circulatory endothelin concentrations in the range 5-40 pmol/l are vasoactive. Consequently, the endothelin concentrations found in patients with CHF may be of pathophysiological significance.
内皮素是最近被确认的血管收缩肽。由于慢性心力衰竭（CHF）的特征是外周小动脉和肾血管收缩，我们检测了患有该综合征患者的静脉血浆中内皮素样免疫反应性（“内皮素”）。
与年龄和性别匹配的健康志愿者相比（平均±标准误血浆内皮素浓度6.4±0.3 pmol/l，n = 16），重度CHF患者外周静脉内皮素浓度升高（12.4±0.6 pmol/l，n = 47，p<0.01）。正常受试者和患者运动时血浆内皮素均未升高。CHF患者（n = 21）的血浆内皮素浓度（平均，13.4±0.9 pmol/l）与血浆心钠素浓度（平均，88.9±11.9 pg/ml）不相关。CHF患者（n = 34）的血浆内皮素与血清尿素之间或内皮素与血清肌酐之间也无相关性。然而，CHF患者（n = 13）存在显著的内皮素肾摄取（主动脉，11.1±0.8 pmol/l；肾静脉，8.8±0.6 pmol/ml；p = 0.02）。
有证据表明，循环内皮素浓度在5 - 40 pmol/l范围内具有血管活性。因此，CHF患者中发现的内皮素浓度可能具有病理生理学意义。
