CAP 123 Endothelin-1 as a predictor of positive ischemic diagnosis during dobutamine stress echocardiography
✍ Scribed by Wen-Jin Cherng; Chao-Hung Wang; Ming-Jui Hung
- Book ID
- 104324776
- Publisher
- Elsevier Science
- Year
- 1997
- Tongue
- English
- Weight
- 159 KB
- Volume
- 23
- Category
- Article
- ISSN
- 0301-5629
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✦ Synopsis
Endothelin is a naturally oaxuring polypeptide substance with potent vasoconstrictive actions. Plasma endothelin-I (ET-l) level was a predictor of prognosis during early stages of acute myocardial infarction. The aim of this study was to test the hypothesis that plasma ET-l levels in patients with ischemic heart disease are related either to myocardial ischemia or left ventricular (LV) dysfunction during dobutamine stress echocardiography. Plasma levels of ET-l were measured in 37 patients against normal controls (group I, n=l l), positive stress echocardiograpby with resting ejection fraction (EF) more than 50% (group II, n=16), and positive stress test with resting EF less than 50% (group III, n=lO). All 3 patient groups were subjected to Thallium 201 scintigraphy and coronary angiography studies. There was no significant difference among patients in these 3 groups with respect to age, gender, blood pressure, and heart rate. The resting LV end-diastolic pressure were higher significantly m group III (26M mmHg) and group II (19ti mmHg) as compared to group I (14f3 rmnHg). The EF of LV decreased significantly in group III as compared to group I and group II (43f12 vs 68*1%, and vs 67*7%, respectively). The cardiac output during stressed state was higher significantly in group I patients as compared to group III. In the resting state, there were higher ET-1 concentrations in group II and group III patients compared to group I (289k183 vs 151f54 pg/rnl, ~0.05 and 3015167 vs 151154 pg/ml, FO.05). During the peak dose of dobutamine infusion, the ET-l increased 59.6% of baseline in group I. However, there levels were reduced in group II (-0.02%) and group III (-10.3%). In conclusion, patients with suspected ischemic heart disease, the concentration of ET-l may predict signiticant anatomical and functional coronary artery disease. However, ET-l does not play a pathophysiological role during an ischemic attack.