Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure
Abstract Aims Endothelin‐1 (ET‐1) is a potent vasoconstrictor, which regulates renal and vascular function. We aimed to relate plasma levels of ET‐1 with the clinical picture and outcomes in acute heart failure (AHF). Methods and results We studied 113 patients with AHF [mean age 65 ± 13 (years), me...
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doaj-15dbaea38ca24ffea163939ec1efbd172021-02-24T06:51:28ZengWileyESC Heart Failure2055-58222020-12-01763536354410.1002/ehf2.13064Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failureRobert Zymliński0Radosław Sierpiński1Marco Metra2Gad Cotter3Mateusz Sokolski4Paweł Siwołowski5Mateusz Garus6Piotr Gajewski7Joanna Tryba8Maria Samorek9Ewa A. Jankowska10Jan Biegus11Piotr Ponikowski12Department of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandCollegium Medicum Cardinal Stefan Wyszyński University in Warsaw Warsaw PolandCardiology, The Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia Brescia ItalyMOMENTUM Research Durham NC USADepartment of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandCentre for Heart Diseases Military Hospital Wrocław PolandDepartment of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandDepartment of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandStudent Scientific Organization, Department of Heart Diseases Wroclaw Medical University Wrocław PolandStudent Scientific Organization, Department of Heart Diseases Wroclaw Medical University Wrocław PolandDepartment of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandDepartment of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandDepartment of Heart Diseases Wroclaw Medical University Borowska 213 Wrocław 50‐556 PolandAbstract Aims Endothelin‐1 (ET‐1) is a potent vasoconstrictor, which regulates renal and vascular function. We aimed to relate plasma levels of ET‐1 with the clinical picture and outcomes in acute heart failure (AHF). Methods and results We studied 113 patients with AHF [mean age 65 ± 13 (years), median (upper and lower quartiles) N‐terminal pro‐B‐type natriuretic peptide, 5422 (2689; 8582) (pg/mL)], in whom plasma levels of ET‐1 were serially measured at admission (10.8 ± 5.2), Day 1 (9.5 ± 3.4), and Day 2 (8.9 ± 3.8) (pg/mL). The population was divided into tertiles across baseline ET‐1 levels. Patients in the highest ET‐1 tertile had predominant clinical signs of peripheral congestion; however, no difference was observed in pulmonary congestion and severity of dyspnoea. They also presented lower spot urine sodium at admission (75 ± 35 vs. 99 ± 43 vs. 108 ± 30), 6 h (84 ± 34 vs. 106 ± 43 vs. 106 ± 35), and Day 1 (75 ± 38 vs. 96 ± 36 vs. 100 ± 35) (mmol/L), when compared with the second and first tertile, respectively (all P < 0.05); furthermore, they received higher doses of intravenous furosemide from Day 2 and had longer intravenous diuretics, as median switch to oral furosemide was 4 (3; 4) vs. 3 (2; 4) vs. 2 (2; 3) (days), respectively, P < 0.05. There was no difference in serum creatinine, urea, and renal injury biomarkers (kidney injury molecule‐1, serum cystatin C, and urine neutrophil gelatinase‐associated lipocalin) between the ET‐1 tertiles. Higher values of ET‐1 measured at each time point were related with a higher risk of 1 year mortality. Conclusions Elevation of ET‐1 is related to clinical signs of peripheral congestion, low urine sodium excretion, and poor outcome in AHF.https://doi.org/10.1002/ehf2.13064NatriuresisRenal functionSpot urine sodiumCongestionEndothelin‐1 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Robert Zymliński Radosław Sierpiński Marco Metra Gad Cotter Mateusz Sokolski Paweł Siwołowski Mateusz Garus Piotr Gajewski Joanna Tryba Maria Samorek Ewa A. Jankowska Jan Biegus Piotr Ponikowski |
spellingShingle |
Robert Zymliński Radosław Sierpiński Marco Metra Gad Cotter Mateusz Sokolski Paweł Siwołowski Mateusz Garus Piotr Gajewski Joanna Tryba Maria Samorek Ewa A. Jankowska Jan Biegus Piotr Ponikowski Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure ESC Heart Failure Natriuresis Renal function Spot urine sodium Congestion Endothelin‐1 |
author_facet |
Robert Zymliński Radosław Sierpiński Marco Metra Gad Cotter Mateusz Sokolski Paweł Siwołowski Mateusz Garus Piotr Gajewski Joanna Tryba Maria Samorek Ewa A. Jankowska Jan Biegus Piotr Ponikowski |
author_sort |
Robert Zymliński |
title |
Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure |
title_short |
Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure |
title_full |
Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure |
title_fullStr |
Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure |
title_full_unstemmed |
Elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure |
title_sort |
elevated plasma endothelin‐1 is related to low natriuresis, clinical signs of congestion, and poor outcome in acute heart failure |
publisher |
Wiley |
series |
ESC Heart Failure |
issn |
2055-5822 |
publishDate |
2020-12-01 |
description |
Abstract Aims Endothelin‐1 (ET‐1) is a potent vasoconstrictor, which regulates renal and vascular function. We aimed to relate plasma levels of ET‐1 with the clinical picture and outcomes in acute heart failure (AHF). Methods and results We studied 113 patients with AHF [mean age 65 ± 13 (years), median (upper and lower quartiles) N‐terminal pro‐B‐type natriuretic peptide, 5422 (2689; 8582) (pg/mL)], in whom plasma levels of ET‐1 were serially measured at admission (10.8 ± 5.2), Day 1 (9.5 ± 3.4), and Day 2 (8.9 ± 3.8) (pg/mL). The population was divided into tertiles across baseline ET‐1 levels. Patients in the highest ET‐1 tertile had predominant clinical signs of peripheral congestion; however, no difference was observed in pulmonary congestion and severity of dyspnoea. They also presented lower spot urine sodium at admission (75 ± 35 vs. 99 ± 43 vs. 108 ± 30), 6 h (84 ± 34 vs. 106 ± 43 vs. 106 ± 35), and Day 1 (75 ± 38 vs. 96 ± 36 vs. 100 ± 35) (mmol/L), when compared with the second and first tertile, respectively (all P < 0.05); furthermore, they received higher doses of intravenous furosemide from Day 2 and had longer intravenous diuretics, as median switch to oral furosemide was 4 (3; 4) vs. 3 (2; 4) vs. 2 (2; 3) (days), respectively, P < 0.05. There was no difference in serum creatinine, urea, and renal injury biomarkers (kidney injury molecule‐1, serum cystatin C, and urine neutrophil gelatinase‐associated lipocalin) between the ET‐1 tertiles. Higher values of ET‐1 measured at each time point were related with a higher risk of 1 year mortality. Conclusions Elevation of ET‐1 is related to clinical signs of peripheral congestion, low urine sodium excretion, and poor outcome in AHF. |
topic |
Natriuresis Renal function Spot urine sodium Congestion Endothelin‐1 |
url |
https://doi.org/10.1002/ehf2.13064 |
work_keys_str_mv |
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