Big endothelin, interleukin 6 and right ventricle function
Authors:
L. Špinarová 1; †j. Toman 1; J. Meluzín 1; P. Hude 1; J. Krejčí 1; H. Pavelčíková 1; J. Tomandl 2; J. Vítovec 1
Authors‘ workplace:
I. interní kardio-angiologická klinika Lékařské fakulty MU a FN u sv. Anny, Brno, přednosta prof. MUDr. Jiří Vítovec, CSc.
1; Biochemický ústav Lékařské fakulty MU, Brno, přednosta prof. MUDr. Vladimír Palyza, CSc.
2
Published in:
Vnitř Lék 2005; 51(9): 965-970
Category:
Original Contributions
Overview
Objective:
Big endothelin (BE) and interleukin 6 (IL 6) belong to important active substances, which are related to severity of heart failure. We compared patients with high and low levels of BE and IL 6 in relation to haemodynamics, left (LV) and right ventricle (RV) functions.
Population:
155 patients with chronic heart failure, left ventricular ejection fraction (LVEF) below 40 %, NYHA II–IV, mean age 51.8 ± 8.8 years, 129 men, 26 women. 86 patients were diagnosed with ischaemic heart disease (IHD), 69 patients had dilatation cardiomyopathy (DCMP).
Methods:
Echocardiography with LV sizes, LV volumes and LVEF measurements, tissue Doppler echocardiography (TDE) of tricuspidal annulus movements with systolic rate (Sa) determination, early diastolic (Ea) and late diastolic rate (Aa), right-sided catheterisation with mean pressure in pulmonary artery (PA), pulmonary capillary wedge pressure (PCWP), atrial pressure (CVP), and pulmonary vascular resistance (PVR) measurements. Values of big endothelin and interleukin 6 were determined by means of ELISA method. Median value of big endothelin was 1.66 pmol/l, median value of interleukin 6 was 2.3 ngl/l. Group A had BE ≥ 1.66 pmol/l, group B < 1.66 pmol/l. In IL 6 assessment group A’ had level ≥ 2.3 ng/l and group B’ < 2.3 ng/l.
Results:
Patients with higher level of BE, group A, had values markedly higher during right-sided catheterisation: PA 31.5 ± 12.8 vs. 23.9 ± 11.6 mm Hg, p < 0.0004, PCWP 22.1 ± 9.8 vs. 16.4 ± 9.1 mm Hg, p < 0.005. Sa, which reflects RV systolic function, was lower in group A: 10.4 ± 2.3 vs. 11.6 ± 2.4 cm/s, p < 0.02. Likewise RV size was higher in group A: 34.0 ± 7.0 vs. 30.8 ± ± 6.5 mm, p < 0.03. Patients with higher value of IL 6, group A’, had larger size of RV as well, 34.0 ± 7.4 vs. 30.1 ± 6.4 mm, p < 0.03, and lower Sa: 10.4 ± 2.2 vs. 11.8 ± 2.4 cm/s, p < 0.0005. There were no differences between groups during right-sided catheterisation: AP 27.9 ± 12.6 vs. 27.3 ± 12 mm Hg, non-significant, and PCWP 19.1 ± 9.8 vs. 19.7 ± 10.0 mm Hg, non-significant.
Conclusion:
Big endothelin and interleukin 6 levels are higher in patients who have systolic dysfunction of the left ventricle accompanied with more pronounced disorder of the right ventricle function than in patients who have disorder of the left cardiac ventricle only.
Key words:
big endothelin – interleukin 6 – right ventricle – tissue Doppler imaging
Sources
1. Berry C, Clark AL. Catabolism in chronic heart failure. Eur Heart J 2000; 21: 521-532.
2. Bartůněk L. Endoteliny a chronická srdeční insuficience. Vnitř Lék 2000; 46(1): 54-57.
3. Burgess MI, Bright-Thomas RJ, Ray SG et al. Echocardiographic evaluation of right ventricular function. Eur J Echocard 2002; 3: 252-262.
4. Cacoub P, Dorent R, Nataf P et al. Plasma endothelin and pulmonary pressures in patients with congestive heart failure. Am Heart J 1993; 126: 1484-1488.
5. Coats AJ et al. Controversies in the management of heart failure. London: Churchill Livingstone 1997.
6. De Groote P, Millaire A, Foucher-Hossein Nugue O et al. Right ventricular ejection fraction is an independent predictor of survival of patients with moderate heart failure. J Am Coll Cardiol 1998; 32: 948-954.
7. Di Salvo TG, Mathier M, Semigran MJ et al. Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure. J Am Coll Cardiol 1995; 25: 1143-1152.
8. Hrazdira I, Kotulánová E, Maryšková V. Barevné dopplerovské metody a jejich význam. Vnitř Lék 2003; 49(7): 563-566.
9. Mandysová E, Niederle P, Mandys F. Variace trikuspidálního průtoku za různých fyziologických podmínek. Cor Vasa 1995; 37: 168-174.
10. McMurray JJ, Simon GR, Abdullah I et al. Plasma endothelin in chronic heart failure. Circulation 1992; 85: 1374-1379.
11. Meluzín J, Eisenberger M. Echokardiografické hodnocení funkce pravé komory. Cor Vasa 2003; 45: 492-500.
12. Meluzin J, Spinarova L, Dusek L et al. Prognostic importance of the right ventricular function assessed by Doppler tissue imaging. Eur J Echocard 2003; 4: 262-271.
13. Meluzin J, Spinarova L, Bakala J et al. Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion. A new, rapid, a non-invasive method for evaluating right ventricular systolic function. Eur Heart J 2001; 22: 340-348.
14. Miller D, Farah GM, Liner A et al. The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance. J Am Soc Echocard 2004; 17: 443-447.
15. Niederle P et al. Echokardiografie. Praha: Triton 2002.
16. Niederle P, Jezek V, Jezkova J et al. Three echocardiographic methods in right ventricular function evaluation. Cardiology 1991; 78: 334-339.
17. Pacher R, Stanek B, Huelsman M et al. Prognostic impact of big endothelin-1 plasma concentrations compared with invasive hemodynamic evaluation in severe heart failure. J Am Coll Cardiol 1996; 27: 633-641.
18. Sharma RB, Coats AJ, Anker S. The role of inflammatory mediators in chronic heart failure: cytokines, nitric oxide, and endothelin-1. Int J Cardiol 2000; 72: 175-186.
19. Schiller NB, Shah PM, Crawford M et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocard 1989; 2: 358-367.
20. Špinar J, Špinarová L, Vítovec J et al. Big endotelin a chronické srdeční selhání. Vnitř Lék 2002; 48(1): 3-7.
21. Spinar J, Vitovec J, Spac J et al. Non-invasive prognostic factors in chronic heart failure. One year survival of 300 patients with diagnosis of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy. Int J Cardiol 1996; 56: 283-288.
22. Spinar J, Vitovec J, Spinarova L et al. The value of big endothelin and hemodynamic variables in heart transplant candidates. Cor Vasa 2000; 42: 495-500.
23. Spinarova L, Toman J, Pospišilova J et al. Humoral response in patients with chronic heart failure. Int J Cardiol 1998; 65: 227-232.
24. Špinarová L, Toman J Humorální změny u chronického srdečního selhání. Cor Vasa 2001; 43: 513-519.
25. Spinarova L, Toman J, Stejfa M et al. Systolic and diastolic function in patients with chronic heart failure at rest and during exercise. Int J Cardiol 1997; 59: 251-256.
26. Tsujinaka T, Fujita J, Ebisui C et al. Interleukin 6 receptor antibody inhibits muscle atrophy and modulates proteolytics systems in interleukin 6 transgenic mice. J Clin Invest 1996; 97: 244-249.
27. Tsutamoto T, Wada A, Maeda Y et al. Relation between endothelin-1 spillover in the lungs and pulmonary vascular resistance in patients with chronic heart failure. J Am Coll Cardiol 1994; 23: 1427-1433.
28. Waggoner AD, Bierig M. Tissue Doppler Imaging: A useful echocardiographic method for the cardiac sonographer to assess systolic and diastolic ventricular function. J Am Soc Echocard 2001; 14: 1143-1152.
29. Widimský J. Srdeční selhání. 2. ed. Praha: Triton 2003.
30. Yanagisawa M, Kurihana H, Kimura S et al. A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 1988; 332: 411-415.
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