Plasma endothelin in congestive heart failure: a predictor of cardiac death?

BACKGROUND: Endothelin is a potent vasoconstrictor, with growth-promoting and possible cardiotoxic and arrhythmogenic properties. This study investigates the association between increased plasma endothelin in congestive heart failure and prognosis.

METHODS AND RESULTS: Forty-four patients with congestive heart failure showed increased plasma endothelin concentrations (mean +/- SD, 3.7 +/- 1.7 pg/mL; n = 44) compared with healthy volunteers (2.0 +/- 0.4 pg/mL, n = 21, P < .00003). Plasma endothelin increased with the severity of the disease. All patients were followed for an average of 17 months (range, 2-25 months). Cardiac mortality was 27% (8 of 30 patients) in the group with plasma endothelin concentrations above 3 pg/mL and 0% (0 of 14 patients) in the group with plasma endothelin concentrations below 3 pg/mL (P < .05). In contrast, separation of patients based on different New York Heart Association groups and ejection fractions revealed no significant difference regarding this endpoint.

CONCLUSIONS: Increased plasma endothelin concentrations in patients with congestive heart failure appears to serve as a predictor of cardiac death.