[Correlation between plasma level of endothelin-1 and heart remodeling in dilated cardiomyopathy].

UNLABELLED

The link between plasma level of endothelin-1 (ET-1) and heart failure has been established. This study demonstrate the role of endothelin-1 in progression of morphological and haemodynamic alteration of heart in patients with dilatative cardiomyopathy.

MATERIALS AND METHODS

We included 71 patients with dilatative cardiomyopathy (ischemic and/or alcoholic)--36 men (50.7%) and 35 women (49.3%). We excluded patients who suffered from chronic renal failure, malignancies, systemic autoimmune disorders, liver cirrhosis. The echocardiography evaluated the chambers dimensions, valvular regurgitations, ejection and shortening fraction, systolic pulmonary artery pressure, cardiac output. All patients were assessed with endothelin-1 and usual hematological and biochemical tests, chest X-ray and electrocardiogram.

RESULTS

The plasma level of endothelin-1 was increased of all patients (5.2775 +/- 2.65 fmol/ml). The value of ET-1 was associated with NYHA class of congestive heart failure (p < 0.000002). All patients were ejection fraction low (< 40%) and it was strongly associated with high level of plasma ET-1 (p < 0.001). The shortening fraction was very low at 87.32% of patients (value was between 5% and 15%) and the relation with ET-1 was significantly (r = - 0.3911, p = 0.001). The same relation was between ET-1 and tele-diastolic and telesystolic left ventricular volume (p = 0.026, respectively, p = 0.001), regional kinetics alteration (p = 0.023), systolic pulmonary arterial pressure (p = 0.0001, r = 0.71) and cardiac output (p = 0.0234).

CONCLUSIONS

The plasma level of endothelin-1 is high at all patients with dilatative cardiomyopathy. Functional and morphological heart alterations are tightly connected to the changes of the endothelin system.