Plasma Endothelin‐1 in patients with atrial septal defect – the novel diagnostic indicator (RCD code: IV-2B.1)
Journal Title: Journal of Rare Cardiovascular Diseases - Year 2015, Vol 2, Issue 3
Abstract
Background: The study aimed to assess the level of plasma Endothelin-1 (ET-1) in patients before and after transcatheter closure of atrial septal defect (ASD) and to evaluate the usefulness of measuring ET-1 levels for the diagnosis and selection of candidates for ASD closure.Methods: 21 patients (11 F, 10 M), mean age 40.2 ± 11.9 years with pulmonary artery hypertension were enrolled for an attempt at ASD closure. A group of 19 healthy volunteers, (12 F, 7 M) mean age 39.2 ± 9.15 served as controls. All ASD patients underwent: clinical and echocardiographic study and cardiopulmonary exercise test. ET-1 levels were measured before and after closure. Whole blood was collected from femoral artery and vein and from pulmonary artery during cardiac catheterization.Results: ET-1 levels at peripheral artery and vein in ASD patients were significantly higher than in the volunteers (p<0.0001). The ASD subjects with highest ET-1 level presented the larger area of right ventricle and right atrium and higher pulmonary artery systolic pressure(p<0.05). The ASD subjects with lower ET-1 level demonstrated longer time of exercise and higher peak oxygen consumption (p<0.05). There was a decrease of ET-1 at peripheral artery (5.549 ± 5.32 vs. 1.92 ± 7.2; p<0.001) and at peripheral vein (4.012 ± 2.342 vs. 2.15 ± 1.15; p<0.001) within 48 hours after ASD closure, as compared to the baseline data. After 6 and 12 months farther drop in ET-1 level was observed.Conclusions: 1. The level of ET-1 in patients with ASD and pulmonary artery hypertension is elevated in compare to healthy subject. 2. The significant reduction of ET-1 level is observed after percutaneous closure of ASD.3. Elevated level of ET-1 in patients with ASD is associated with right heart enlargement. 4. Measurements of ET-1 may be a supplemental diagnostic tool and may be helpful in establishing indications for defect closure.
Authors and Affiliations
Monika Komar, Jakub Podolec, Urszula Gancarczyk, Wojciech Płazak, Bartosz Sobień, Lidia Tomkiewicz‐Pająk, Piotr Wilkołek, Tadeusz Przewłocki
Keywords
Related Articles
- EP ID EP245467
- DOI 10.20418/jrcd.vol2no3.184
- Views 80
- Downloads 0
Cardiac manifestations in a two‑generation family with Fabry disease (RCD code: III‑2B.2a)
Fabry disease (FD), which is also called angiokeratoma corporis difusum, ceramide trihexosidosis, and Anderson-Fabry disease, is an X-linked inborn error of metabolism of glycosphingolipid pathway. It is caused by the de...
Severe aortic regurgitation and pulmonary hypertension in an 18‑year‑old patient after balloon aortic valvuloplasty (RCD code: IV‑5.A2)
Aortic stenosis is the most common form of congenital left ventricle outflow tract obstruction. It may be a life threatening ductal-dependent condition in newborns and necessitating urgent percutaneous balloon aortic val...
Isolated right ventricular endomyocardial fibrosis in a young male with chronic myeloid leukemia (RCD code: III‑3F.2)
Endomyocardial fibrosis (EMF) is a rare disease of unknown etiology which is more prevalent in tropical countries. EMF is associated with fibrosis of endomyocardium, involving one or both ventricles. It usually presents...
Aortic arch aneurysm (RCD code: I-2A.O)
An aortic aneurysm is defined as a pathologic dilatation to more than 1.5 times the normal diameter of the aorta. The prognosis is serious; several segments of the aorta can be dilated concomitantly. The wall of the aort...
Pulmonary arterial hypertension in a patient with unilateral pulmonary artery absence (RCD code: II-2A.1)
Pulmonary artery absence is a rare congenital defect, occurring in 1 out of 100 000 individuals. In its isolated unilateral form only one in three cases concerns the left artery. The first symptoms usually appear in youn...