Plasma Endothelin in Chronic Heart Failure

Background. Endothelins are recently characterized vasoconstrictor peptides. As chronic heart failure (CHF) is characterized by peripheral arteriolar and renal vasoconstriction, we have measured venous plasma endothelin-like immunoreactivity ("endothelin") in patients with this syndrome. Methods and Results. Compared with ageand sex-matched healthy volunteers (mean±SEM plasma endothelin concentration 6.4±0.3 pmol/l, n=16), patients with severe CHF had elevated peripheral venous endothelin concentrations (12.4±0.6 pmol/l, n =47, p <0.01). Plasma endothelin did not increase with exercise in normal subjects or in patients. Plasma endothelin concentration (mean, 13.4+0.9 pmol/l) did not correlate with plasma atrial natriuretic factor concentration (mean, 88.9±11.9 pg/ml) in patients with CHF (n=21). There was also no correlation between plasma endothelin and serum urea or between endothelin and serum creatinine in patients with CHF (n=34). There was, however, significant renal extraction of endothelin (aorta, 11.1+0.8 pmol/l; renal vein, 8.8±0.6 pmol/l;p=0.02) in patients with CHF (n=13). Conclusions. Evidence suggests that circulatory endothelin concentrations in the range 5-40 pmol/l are vasoactive. Consequently, the endothelin concentrations found in patients with CHF may be of pathophysiological significance. (Circulation 1992;85:1374-1379)