Plasma Endothelin‐1 in patients with atrial septal defect – the novel diagnostic indicator (RCD code: IV-2B.1)
Journal Title: Journal of Rare Cardiovascular Diseases - Year 2015, Vol 2, Issue 3
Abstract
Background: The study aimed to assess the level of plasma Endothelin-1 (ET-1) in patients before and after transcatheter closure of atrial septal defect (ASD) and to evaluate the usefulness of measuring ET-1 levels for the diagnosis and selection of candidates for ASD closure.Methods: 21 patients (11 F, 10 M), mean age 40.2 ± 11.9 years with pulmonary artery hypertension were enrolled for an attempt at ASD closure. A group of 19 healthy volunteers, (12 F, 7 M) mean age 39.2 ± 9.15 served as controls. All ASD patients underwent: clinical and echocardiographic study and cardiopulmonary exercise test. ET-1 levels were measured before and after closure. Whole blood was collected from femoral artery and vein and from pulmonary artery during cardiac catheterization.Results: ET-1 levels at peripheral artery and vein in ASD patients were significantly higher than in the volunteers (p<0.0001). The ASD subjects with highest ET-1 level presented the larger area of right ventricle and right atrium and higher pulmonary artery systolic pressure(p<0.05). The ASD subjects with lower ET-1 level demonstrated longer time of exercise and higher peak oxygen consumption (p<0.05). There was a decrease of ET-1 at peripheral artery (5.549 ± 5.32 vs. 1.92 ± 7.2; p<0.001) and at peripheral vein (4.012 ± 2.342 vs. 2.15 ± 1.15; p<0.001) within 48 hours after ASD closure, as compared to the baseline data. After 6 and 12 months farther drop in ET-1 level was observed.Conclusions: 1. The level of ET-1 in patients with ASD and pulmonary artery hypertension is elevated in compare to healthy subject. 2. The significant reduction of ET-1 level is observed after percutaneous closure of ASD.3. Elevated level of ET-1 in patients with ASD is associated with right heart enlargement. 4. Measurements of ET-1 may be a supplemental diagnostic tool and may be helpful in establishing indications for defect closure.
Authors and Affiliations
Monika Komar, Jakub Podolec, Urszula Gancarczyk, Wojciech Płazak, Bartosz Sobień, Lidia Tomkiewicz‐Pająk, Piotr Wilkołek, Tadeusz Przewłocki
Keywords
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- EP ID EP245467
- DOI 10.20418/jrcd.vol2no3.184
- Views 99
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