INCREASED RENAL FORMATION OF THROMBOXANE A(2) AND PROSTAGLANDIN-F2-ALPHA IN HEART-FAILURE

Renal formation of the vasoconstrictor prostaglandins thromboxane A(2) (TXA(2)) and prostaglandin F-2 alpha (PGF(2 alpha)) was investigated in 25 patients with cardiac failure, divided into New York Heart Assoc iation functional classes I to IV, and in eight healthy control subjec ts. Plasma renin activity (PRA) and hemodynamic parameters were also i nvestigated. Renal vasoconstrictor eicosanoid formation, measured in u rinary daily excretion, was not different between patients in class I and control subjects. Class II to IV patients showed progressively inc reasing production of PGF(2 alpha) (F = 49.8, p < 0.001, analysis of v ariance) and TXA(2) (F = 37.8, p < 0.002). PGF(2 alpha) excretion peak ed in class IV (+1266% vs class I, p < 0.001). Compared with class I, urinary excretion of thromboxane B-2 was +816% in class III and +1561% in class IV (both p < 0.001). PRA was significantly increased only in class IV (+1558%, p < 0.001). The current results indicate a progress ive increase in renal production of vasoconstrictor eicosanoids direct ly related to New York Heart Association class and suggest that these prostanoids may have a role in deterioration of renal function.