Lechleitner P, Genser N, Mair J, Maier J, Artner-Dworzak E, Dienstl F, Puschendorf B
Department of Internal Medicine, University of Innsbruck, Austria.
Clin Chem. 1993 Jun;39(6):955-9.
Endothelin is a potent vasoconstrictor of coronary arteries. We measured plasma concentrations of immunoreactive endothelin (irET) in 46 patients with confirmed acute myocardial infarction (AMI). When compared with irET concentrations in healthy individuals who served as controls, irET concentrations in patients were already significantly elevated at the time of admission (P = 0.002) and remained significantly elevated for at least 2 days after AMI (P < 0.01). IrET concentrations peaked 1 h (mean) after admission (8.5 +/- 3.9 ng/L, P = 0.02 compared with values at time of admission). Reperfusion of the infarct-related artery markedly influenced irET release. Before the start of thrombolytic therapy, irET concentration in patients with early reperfusion did not differ significantly from that of those without early reperfusion. However, irET time courses were significantly (P = 0.03 by analysis of variance) different in patients who did and did not have early reperfusion. In the latter, peak irET concentrations correlated closely with the angiographic left ventricular ejection fraction (r = -0.71, P = 0.03), maximum creatine kinase MB mass concentrations (r = 0.69, P = 0.01), and creatine kinase activities (r = 0.59, P = 0.03). Reflow and reversion of myocardial ischemia are associated with a reduced irET release in patients with AMI.
内皮素是冠状动脉的一种强效血管收缩剂。我们测定了46例确诊为急性心肌梗死（AMI）患者血浆中免疫反应性内皮素（irET）的浓度。与作为对照的健康个体的irET浓度相比，患者的irET浓度在入院时就已显著升高（P = 0.002），并且在AMI后至少2天内仍显著升高（P < 0.01）。irET浓度在入院后1小时（平均）达到峰值（8.5 +/- 3.9 ng/L，与入院时的值相比，P = 0.02）。梗死相关动脉的再灌注显著影响irET的释放。在溶栓治疗开始前，早期再灌注患者的irET浓度与未早期再灌注患者的irET浓度无显著差异。然而，有早期再灌注和没有早期再灌注的患者的irET时间进程有显著差异（方差分析，P = 0.03）。在后者中，irET峰值浓度与血管造影左心室射血分数密切相关（r = -0.71，P = 0.03）、最大肌酸激酶MB质量浓度（r = 0.69，P = 0.01）和肌酸激酶活性（r = 0.59，P = 0.03）。心肌缺血的再灌注和逆转与AMI患者irET释放减少有关。
