HUMORAL RESPONSE IN PATIENTS WITH CHRONIC HEART-FAILURE

Aim: Correlation of five humoral markers with laboratory, echocardiogr aphic and right heart catheterization parameters in patients with chro nic heart failure. Study population: 29 patients, heart failure NYHA I I, and III, ejection fraction below 40% with coronary artery disease o r dilated cardiomyopathy. Methods: evaluation of thromboxane, prostagl andin F (PGF), tumor necrosis factor (TNF) alpha, endothelin-1 and big endothelin rest levels and their correlation with: (1) laboratory par ameters: Sodium, urea, creatinine, fibrinogen, (2) chest X-ray: cardio thoracic index (CTI), pulmonary congestion, (3) right heart catheteriz ation parameters at rest, hand-grip and bicycle ergometry: mean pulmon ary artery pressure (AP), wedge pressure (WP), systemic and pulmonary vascular resistance (SVR, PVR) and cardiac index (CI), (4) echocardiog raphic parameters at rest, hand-grip and bicycle ergometry: end-diasto lic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), m itral flow E/A, filling period of left ventricle and time of duration of mitral regurgitation. Results: No correlation was found between thr omboxane, prostaglandin F and tumor necrosis factor alpha with the abo ve mentioned parameters. Endothelin-1 level correlated with E/A, PVR a nd MPA at rest and at hand-grip. Big endothelin level correlated with EDV and ESV, AP, WP and SVR at rest and at both types of exercise. The highest correlation was between big endothelin and rest AP (r=0.79), rest WP (r=0.78) and CTI (r=0.58), all P<0.01. Conclusions: Big endoth elin and partly endothelin-1 levels showed a close correlation with so me parameters used for the evaluation of chronic heart failure severit y. (C) 1998 Elsevier Science ireland Ltd.