INCREASED PLASMA ENDOTHELIN CONCENTRATIONS IN PATIENTS WITH ACUTE HEART-FAILURE AFTER MYOCARDIAL-INFARCTION

We have investigated the relationship between plasma endothelin (ET) c oncentrations and several clinical characteristics in 31 patients with acute myocardial infarction (MI). ET levels were also measured in 10 age-matched healthy subjects, 9 patients with unstable angina, and 20 patients with chronic heart disease. In patients with MI, although no significant relationship was observed between plasma ET concentrations and measured hemodynamic parameters, plasma levels were higher in pat ients with pulmonary congestion than in those without this complicatio n (1.61+/-0.29 vs 1.21+/-0.33 fmol/ml; p<0.01). No significant differe nce in plasma ET levels was found between cardiac and peripheral sampl ing sites (pulmonary artery; 1.07+/-0.28, right atrium; 1.02+/-0.28, p eripheral artery; 1.12+/-0.23, peripheral vein; 1.14+/-0.38 fmol/ml: N .S.), or among patients with uncomplicated MI, unstable angina (1.00+/ -0.32 fmol/ml), and healthy subjects (1.01+/-0.29 fmol/ml). Increased level were observed in patients with decompensated heart failure due t o chronic heart disease, but were not found in patients without pulmon ary congestion (1.62+/-0.60 vs 1.11+/-fmol/ml; p<0.01). These observat ions suggest that plasma ET concentrations are elevated in the presenc e of congestive heart failure or severe ventricular depression, but ar e not persistently increased by myocardial ischemia per se.