Reduced pulmonary clearance of endothelin-1 in pulmonary hypertension☆,☆☆,★,★★
Section snippets
Patients
Study protocol and the consent form were designed in accordance with the research and ethics committees of the Montreal Heart Institute. The patients with PHT (n=17) were recruited among patients awaiting diagnostic cardiac catheterization for the following conditions: mitral stenosis (n = 12), congestive heart failure (n = 4), and primary PHT (n = 1). The only criteria for inclusion was the presence of a pulmonary artery systolic pressure of ≥40 mm Hg evaluated by echocardiography within the
Patient characteristics and hemodynamics
The mean age in the control group (59.3 ± 2.9 years) was not different from the PHT group (57.8 ± 2.2 years). Table I shows the hemodynamic parameters for the two groups.
SVR, Systemic Empty Cell Control group PHT Heart rate (beats/min) 65 ± 2 70 ± 2 Mean arterial pressure (mm Hg) 96 ± 2 92 ± 3 SVR (dynes · sec · cm-5) 890 ± 48 1105 ± 123 Mean pulmonary artery pressure (mm Hg) 16 ± 1 28 ± 2* PVR (dynes · sec · cm-5) 72 ± 9 148 ± 29† Cardiac index (L/min/m2) 2.81 ± 0.15 2.41 ± 0.13
Discussion
We used the indicator-dilution technique combined with measurements of immunoreactive ET-1 levels to quantify precisely any alteration in the pulmonary metabolism of circulating ET-1 in patients with PHT.
Acknowledgements
We thank Nathalie Ruel for her expert technical assistance, the staff of the hemodynamic laboratory for their collaboration, and Caroll Boyer and Diane Campeau for preparing the manuscript.
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From the Department of aMedicine, Montreal Heart Institute; b Department of Medicine, Royal Victoria Hospital, Montreal; and c Department of Medicine, St. Michael's Hospital, Toronto.
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Supported by the Medical Research Council of Canada, the Fonds de la Recherche en Santé du Québec, and the Quebec Heart and Stroke Foundation.
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Reprint requests: Jocelyn Dupuis, MD, Research Center, Montreal Heart Institute, 5000 Bélanger Street East, Montreal, Quebec, Canada, H1T 1C8., E-mail: [email protected]
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