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Qu Y, Zhang D, Hu Y, Wang J, Tan H, Qin F, Liu Y. Long-term prognostic value of big endothelin-1 and its combination with late gadolinium enhancement in patients with idiopathic restrictive cardiomyopathy. Clin Chim Acta 2024; 561:119755. [PMID: 38821338 DOI: 10.1016/j.cca.2024.119755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/28/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND AND AIMS Idiopathic restrictive cardiomyopathy (RCM) has a low incidence. This study aimed to determine the prognostic value of big endothelin-1 (ET-1) in idiopathic RCM. MATERIALS AND METHODS We prospectively enrolled patients with idiopathic RCM from 2009 to 2017 and followed them up. The primary outcome was a composite of all-cause mortality and cardiac transplantation, and the secondary outcome was a composite of cardiac death and cardiac transplantation. RESULTS Ninety-one patients were divided into the high big ET-1 (>0.85 pmol/L, n = 56) and low big ET-1 (≤0.85 pmol/L, n = 35) groups, and 87 of them completed the follow-up. Big ET-1 concentrations (hazard ratio: 1.756, 95 % confidence interval [CI]: 1.117-2.760) and late gadolinium enhancement (LGE) (hazard ratio: 3.851, 95 % CI: 1.238-11.981) were independent risk factors for the primary outcome. Big ET-1 concentrations (C-statistic estimation: 0.764, 95 % CI: 0.657-0.871) and the combination of LGE and big ET-1 concentrations (C-statistic estimation: 0.870, 95 % CI: 0.769-0.970) could accurately predict the 5-year transplant-free survival rate, and 0.85 pmol/L was a suitable cutoff for big ET-1. CONCLUSION Big ET-1 and its combination with LGE may be useful to predict an adverse prognosis in patients with idiopathic RCM.
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Affiliation(s)
- Yi Qu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, China
| | - Di Zhang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, China
| | - Yuxiao Hu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, China
| | - Jiayi Wang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, China
| | - Huiqiong Tan
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, China
| | - Fuzhong Qin
- The Second Hospital of Shanxi Medical University, No. 382 Wuyi Road, Taiyuan, Shanxi Province, China
| | - Yaxin Liu
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, China.
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Wang H, Wang C. Prognostic Value of Endothelin-1 or Related Peptides in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis. Angiology 2023:33197231223616. [PMID: 38128149 DOI: 10.1177/00033197231223616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
There is increasing evidence that endothelin-1 (ET-1) or related peptides play a prognostic value in coronary artery disease (CAD). The objective of this systematic review and meta-analysis was to evaluate the predictive role of ET-1 or related peptides in CAD patients. We comprehensively searched PubMed and Embase databases until January 15, 2023. Studies examining the association of ET-1, big ET-1, or C-terminal proendothelin-1 (CT-proET-1) level with all-cause mortality or major adverse cardiovascular events (MACEs) in CAD patients were included. Fourteen studies with 30,181 patients were identified. Comparison of the top and the lowest ET-1 level, the pooled risk ratio (RR) of all-cause mortality was 3.77 (95% confidence interval [CI] 1.59-8.94) for ET-1 and 1.65 (95% CI 1.25-2.18) for big ET-1. The pooled RR of MACEs was 2.24 (95% CI 1.85-2.72) for ET-1, 1.49 (95% CI 1.10-2.03) for big ET-1, and 3.55 (95% CI 2.12-5.96) for CT-proET-1, respectively. Subgroup analysis indicated that elevated ET-1 level was associated with 2.66-fold and 2.09-fold higher risk of in-hospital/30-day and long-term MACEs. Elevated ET-1, big ET-1, or CT-proET-1 may be independently associated with higher risk of all-cause mortality and MACEs in patients with CAD.
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Affiliation(s)
- Hao Wang
- Department of cardiovascular medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Ci Wang
- Department of Senior Cadre Ward, 980 Hospital of PLA Joint Logistics Support Force, Shijiazhuang, China
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Then C, Sujana C, Herder C, Then H, Heier M, Meisinger C, Peters A, Koenig W, Rathmann W, Maalmi H, Ritzel K, Roden M, Stumvoll M, Thorand B, Seissler J. Association of C-Terminal Pro-Endothelin-1 with Mortality in the Population-Based KORA F4 Study. Vasc Health Risk Manag 2022; 18:335-346. [PMID: 35535305 PMCID: PMC9078871 DOI: 10.2147/vhrm.s363814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Endothelin-1 and its prohormone C-terminal pro-endothelin-1 (CT-proET-1) have been linked to metabolic alterations, inflammatory responses and cardiovascular events in selected study populations. We analyzed the association of CT-proET-1 with cardiovascular events and mortality, carotid intima-media-thickness as surrogate for early atherosclerotic lesions, biomarkers of subclinical inflammation and adipokines in a population-based study. Methods The cross-sectional and prospective analyses used data from the KORA F4 study with a median follow-up time of 9.1 (8.8–9.4) years. Data on CT-proET-1 and mortality were available for 1554 participants, data on the other outcomes in subgroups (n = 596–1554). The associations were estimated using multivariable linear regression and Cox proportional hazard models adjusted for sex, age, body mass index, estimated glomerular filtration rate, arterial hypertension, diabetes, low-density and high-density lipoprotein cholesterol, current and former smoking and physical activity. The Bonferroni method was used to correct for multiple testing. Results In the fully adjusted model, CT-proET-1 was associated with cardiovascular (hazard ratio (HR) per standard deviation increase: 1.66; 95% confidence interval (CI): 1.10–2.51; p = 0.017) and all-cause mortality (HR: 2.03; 95% CI 1.55–2.67; p < 0.001), but not with cardiovascular events, and was inversely associated with the intima-media thickness (β: −0.09 ± 0.03; p = 0.001). CT-proET-1 was positively associated with five out of ten biomarkers of subclinical inflammation and with two out of five adipokines after correction for multiple testing. After inclusion of biomarkers of subclinical inflammation in the Cox proportional hazard model, the association of CT-proET-1 with all-cause mortality persisted (p < 0.001). Conclusion These results emphasize the complexity of endothelin-1 actions and/or indicator functions of CT-proET-1. CT-proET-1 is a risk marker for all-cause mortality, which is likely independent of vascular endothelin-1 actions, cardiovascular disease and inflammation.
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Affiliation(s)
- Cornelia Then
- Department of Internal Medicine IV, University Hospital of Ludwigs-Maximilians-University Munich, Munich, Germany
- German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Munich, Germany
- Correspondence: Cornelia Then, Medizinische Klinik und Poliklinik IV - Klinikum der Ludwig-Maximilians-Universität, Ziemssenstraße 1, München, 80336, Germany, Tel +4989440052111, Fax +4989440054956, Email
| | - Chaterina Sujana
- German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, Ludwigs-Maximilians-University Munich, Munich, Germany
| | - Christian Herder
- German Center for Diabetes Research (DZD), Munich, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Holger Then
- Freie Waldorfschule Augsburg, Augsburg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Christa Meisinger
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Chair of Epidemiology, University Hospital Augsburg, Augsburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Wolfgang Koenig
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
- German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Wolfgang Rathmann
- German Center for Diabetes Research (DZD), Munich, Germany
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Haifa Maalmi
- German Center for Diabetes Research (DZD), Munich, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Katrin Ritzel
- Department of Internal Medicine IV, University Hospital of Ludwigs-Maximilians-University Munich, Munich, Germany
| | - Michael Roden
- German Center for Diabetes Research (DZD), Munich, Germany
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Barbara Thorand
- German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum Munich – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jochen Seissler
- Department of Internal Medicine IV, University Hospital of Ludwigs-Maximilians-University Munich, Munich, Germany
- German Center for Diabetes Research (DZD), Partner Munich-Neuherberg, Munich, Germany
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Akseh S, Karimi MA, Safaie N, Valizadeh A, Rahmanpour D, Pezeshkian M, Nouri M, Faridvand Y, Jodati A. The serum levels of testosterone in coronary artery disease patients; relation to NO, eNOS, endothelin-1, and disease severity. Horm Mol Biol Clin Investig 2021; 43:55-61. [PMID: 34496169 DOI: 10.1515/hmbci-2021-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/20/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The changes in testosterone level and its correlation with the endothelial nitric oxide systems balance in patients with coronary artery disease (CAD) remains uncertain. Therefore, in our study, we aimed to evaluate the levels of testosterone, endothelin-1 (ET-1), nitric oxide (NO), and endothelial NOS (eNOS) in CAD patients, and control group to find the relationship between these parameters and disease severity. METHODS Forty-four patients as CAD group with significant (≥50%) stenosis confirmed by angiography was included in the study, and 40 healthy men were included as the control group. According to the number of vessels obstruction, CAD severity was determined. The serum indicated parameters were assessed to discriminate between patients and controls. RESULTS It was found that testosterone levels in the CDA group were significantly lower than those of the control group (p<0.05). In addition, the level of ET-1 in the CAD group was higher than that in the control group, but levels of NO and eNOS in observation were significantly lower than those in the control group (p<0.05). The correlation analysis revealed that testosterone was passivity correlated with serum NO levels (r=0.550, p=0.001). CONCLUSIONS The current study reports that serum levels of testosterone are closely related to endothelial NO levels and might be of relevance to the pathogenesis of endothelial dysfunction and disease severity in CAD patients.
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Affiliation(s)
- Saeideh Akseh
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad-Ali Karimi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasser Safaie
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Valizadeh
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dara Rahmanpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Pezeshkian
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Faridvand
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmadreza Jodati
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Elevated serum endothelin-1 is an independent predictor of coronary microvascular dysfunction in non-obstructive territories in patients with coronary artery disease. Heart Vessels 2021; 36:917-923. [PMID: 33484293 DOI: 10.1007/s00380-020-01767-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Abstract
Endothelin-1 contributes to the constrictor response of the coronary arteries in patients with ischemia with normal coronary arteries. There is thus increasing evidence that endothelin-1 plays a role in coronary microvascular dysfunction (CMD). We investigated whether elevated endothelin-1 is associated with CMD in patients with coronary artery disease (CAD). We prospectively studied 49 consecutive CAD patients with 1- or 2-vessel disease (age 71 ± 10 years, 43 males). Myocardial blood flow (MBF) was measured by 15O-water PET/CT at rest and during stress, and the coronary flow reserve (CFR) was calculated by dividing the stress MBF by the rest MBF. A CFR of less than 2.0 in non-obstructive regions was defined as a marker of CMD. Eighteen out of 49 (37%) CAD patients had CMD. Endothelin-1 in patients with CMD was significantly higher than in those without CMD (2.27 ± 0.81 vs. 1.64 ± 0.48 pg/mL, P = 0.001). Accordingly, univariate ROC analysis showed that the continuous endothelin-1 levels significantly discriminated between the presence and absence of CMD (area under the curve = 0.746 [95%CI 0.592-0.899]). The dichotomous treatment of elevated endothelin-1 as 1.961 pg/mL or more yielded the optimal discriminatory capacity, with a sensitivity of 72.2% and a specificity of 71.0%. High endothelin-1 was still a significant predictor of CMD after adjusting for diabetes mellitus (odds ratio = 6.64 [1.75-25.22], P = 0.005). Endothelin-1 is associated with CMD in non-obstructive territories in patients with CAD, suggesting that endothelin-1 is a potential target for treating CMD in CAD patients.
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Li P, Schmidt IM, Sabbisetti V, Tio MC, Opotowsky AR, Waikar SS. Plasma Endothelin-1 and Risk of Death and Hospitalization in Patients Undergoing Maintenance Hemodialysis. Clin J Am Soc Nephrol 2020; 15:784-793. [PMID: 32381583 PMCID: PMC7274287 DOI: 10.2215/cjn.11130919] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/19/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Endothelin-1 is a potent endothelium-derived vasoconstrictor peptide implicated in the pathogenesis of hypertension, congestive heart failure, and inflammation, all of which are critical pathophysiologic features of CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS To test the hypothesis that plasma endothelin-1 levels are associated with increased risks of mortality and hospitalization in patients with chronic kidney failure, we measured plasma endothelin-1 levels in a prospective cohort of 794 individuals receiving maintenance hemodialysis. The primary outcomes were time to death and time to hospitalization. RESULTS The median plasma endothelin-1 level was 2.02 (interquartile range, 1.57-2.71) pg/ml. During a median follow-up period of 28 (interquartile range, 21-29) months, 253 individuals (32%) died and 643 individuals (81%) were hospitalized at least once. In multivariable models adjusted for demographic, clinical, and laboratory variables, individuals in the highest quartile of plasma endothelin-1 had a 2.44-fold higher risk of death (hazard ratio, 2.44; 95% confidence interval, 1.61 to 3.70) and a 1.54-fold higher risk of hospitalization (hazard ratio, 1.54; 95% confidence interval, 1.19 to 1.99) compared with individuals in the lowest quartile. The Harrell C-statistic of the fully adjusted model increased from 0.73 to 0.74 after addition of natural log-transformed plasma endothelin-1 (P<0.001) for all-cause mortality, and increased from 0.608 to 0.614 after addition of natural log-transformed plasma endothelin-1 (P=0.002) for hospitalization. CONCLUSIONS Higher plasma endothelin-1 is associated with adverse clinical events in patients receiving hemodialysis independent of previously described risk factors. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_05_15_CJN11130919.mp3.
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Affiliation(s)
- Ping Li
- Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Nephrology, State Key Laboratory of Kidney Disease, National Clinical Research Center for Kidney Disease, Chinese PLA General Hospital, Beijing, China
| | - Insa M. Schmidt
- Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Boston University Medical Center, Boston, Massachusetts
| | - Venkata Sabbisetti
- Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maria Clarissa Tio
- Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexander R. Opotowsky
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts
| | - Sushrut S. Waikar
- Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Boston University Medical Center, Boston, Massachusetts
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Abstract
Discovered in 1987 as a potent endothelial cell-derived vasoconstrictor peptide, endothelin-1 (ET-1), the predominant member of the endothelin peptide family, is now recognized as a multifunctional peptide with cytokine-like activity contributing to almost all aspects of physiology and cell function. More than 30 000 scientific articles on endothelin were published over the past 3 decades, leading to the development and subsequent regulatory approval of a new class of therapeutics-the endothelin receptor antagonists (ERAs). This article reviews the history of the discovery of endothelin and its role in genetics, physiology, and disease. Here, we summarize the main clinical trials using ERAs and discuss the role of endothelin in cardiovascular diseases such as arterial hypertension, preecclampsia, coronary atherosclerosis, myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) caused by spontaneous coronary artery dissection (SCAD), Takotsubo syndrome, and heart failure. We also discuss how endothelins contributes to diabetic kidney disease and focal segmental glomerulosclerosis, pulmonary arterial hypertension, as well as cancer, immune disorders, and allograft rejection (which all involve ETA autoantibodies), and neurological diseases. The application of ERAs, dual endothelin receptor/angiotensin receptor antagonists (DARAs), selective ETB agonists, novel biologics such as receptor-targeting antibodies, or immunization against ETA receptors holds the potential to slow the progression or even reverse chronic noncommunicable diseases. Future clinical studies will show whether targeting endothelin receptors can prevent or reduce disability from disease and improve clinical outcome, quality of life, and survival in patients.
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Affiliation(s)
- Matthias Barton
- From Molecular Internal Medicine, University of Zürich, Switzerland (M.B.)
- Andreas Grüntzig Foundation, Zürich, Switzerland (M.B.)
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS) and Life Science Center, Tsukuba Advanced Research Alliance, University of Tsukuba, Japan (M.Y.)
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX (M.Y.)
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Abstract
Background Noncalcified plaques (NCPs) and mixed plaques (MPs) are considered as the high-risk coronary plaques. Endothelin-1 (ET-1) is a vasoactive peptide and shows a high expression in vulnerable plaque. The aim of this study is to investigate the relationship between the bigET-1, the precursor of ET-1, and NCPs/MPs in a Chinese population. Methods and results A total of 513 patients with chest pain and suspected coronary artery disease were collected and divided into three groups with no plaques, calcified plaques, or NCPs/MPs according to the characteristics of all the plaques. It demonstrated that NCPs/MPs were associated with elevated bigET-1 (P < 0.001). Moreover, the proportion of NCPs/MPs was significantly increased from 43.3% in bigET-1 tertile 1 to 61.0% in tertile 3 group (P = 0.001). Multiple logistic regression analysis further showed that bigET-1 was an independent predictor for the presence of NCPs/MPs (odds ratio = 1.858; 95% confidence interval: 1.017–3.394; P = 0.044). Conclusion The bigET-1 could be an independent predictor for the presence of NCPs/MPs. Noncalcified plaques (NCPs) and mixed plaques (MPs) are considered as the high risk coronary plaques. Endothelin- 1(ET-1) is a vasoactive peptide and shows a high expression in vulnerable plaque. However, the relationship between circulating ET-1 and NCPs/MPs is still an unanswered question. In the present study, we found that NCPs and MPs were associated with elevated plasma bigET-1, the precursor of ET-1. The patients with NCPs and MPs had significantly elevated bigET-1, compared to those without coronary plaque or those have calcified plaques. Multiple logistic regression analysis further showed that bigET-1 was an independent predictor for the presence of NCPs/MPs. The finding highlights the potential value of this assay in predicting the characteristics of plaques in patients with suspected or known coronary artery disease.
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Theuerle J, Farouque O, Vasanthakumar S, Patel SK, Burrell LM, Clark DJ, Al-Fiadh AH. Plasma endothelin-1 and adrenomedullin are associated with coronary artery function and cardiovascular outcomes in humans. Int J Cardiol 2019; 291:168-172. [PMID: 30987836 DOI: 10.1016/j.ijcard.2019.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/10/2019] [Accepted: 04/01/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Endothelin-1 (ET-1) is a vasoconstrictor associated with cardiovascular disease, whereas adrenomedullin (ADM) is a vasorelaxant with cardioprotective properties. We sought to determine the relationship between plasma ET-1 and ADM with coronary circulatory function and long-term major adverse cardiovascular events (MACE). METHODS Thirty-two patients undergoing coronary angiography for chest pain were recruited. Baseline plasma ET-1 and ADM levels were measured. The index of microcirculatory resistance (IMR), coronary flow mediated dilatation (cFMD) and coronary flow reserve (CFR) were measured in a non-obstructed coronary artery. Patients were assessed for MACE over a median period of 8.8 years. RESULTS Plasma ET-1 levels correlated with IMR (r = 0.57; p < 0.01) and ADM levels correlated with CFR (r = 0.50; p = 0.04) and cFMD (r = 0.62; p = 0.01). After adjustment for age, gender and cardiovascular risk factors, the association between ADM and cFMD (β = 0.79; p < 0.01) and between ET-1 and IMR (β = 5.7; p = 0.01) remained significant. IMR was higher, although not statistically significant, in patients with long-term MACE (17.9 ± 5.3 vs. 13.1 ± 6.0 units; p = 0.14). In patients free of MACE, cFMD (9.3 ± 7.6 vs. 2.8 ± 5.0%; p = 0.01) and plasma ADM levels (7.6 ± 5.3 vs. 4.0 ± 1.9 pmol/L; p = 0.07) were higher. CONCLUSIONS Plasma ET-1 and ADM were associated with measures of coronary microvascular and coronary conduit vessel function, respectively. Increased cFMD and elevated plasma ADM were associated with a cardioprotective effect.
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Affiliation(s)
- James Theuerle
- Department of Cardiology, Austin Health, Melbourne, Australia
| | - Omar Farouque
- Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia.
| | | | - Sheila K Patel
- Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia
| | - Louise M Burrell
- Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia
| | - David J Clark
- Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia
| | - Ali H Al-Fiadh
- Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Australia
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