Endothelin abnormalities in patients with pulmonary embolism.
BACKGROUND
Endothelin (ET) is an endothelium-derived multifunctional peptide involved in the local regulation of the vascular tone.


OBJECTIVE
To assess changes of endogenous ET production/excretion in the acute phase (36 h from the event) of pulmonary embolism (PE).


METHODS
Ten patients with acute PE, nine patients with acute lung injury (ALI), and 12 healthy volunteers (HVs).


RESULTS
ET was detected by radioimmunoassay in venous and arterial blood as well as in 24-h urine specimens. For each subject, arterial/venous immunoreactive ET (ir-ET) ratio was evaluated as an index of its pulmonary extraction/synthesis. Creatinine clearance was employed in each case to obtain a corrected renal ir-ET clearance. Renal ir-ET clearance was comparable in all three groups. Arterial/venous ir-ET ratio was comparable in PE and in ALI patients (1.31 +/- 0.25 vs 1.24 +/- 0.20; p = 0.7), while it was significantly higher in PE patients than in HV subjects (0.85 +/- 0.07; p = 0.0001). Accordingly, 24-h urine ir-ET excretion was higher in PE (120.50 +/- 27.36 ng/24 h) and ALI patients (135.80 +/- 21.60 ng/24 h) than in HV subjects (68.33 +/- 9.31 ng/24 h; p = 0.0001).


CONCLUSIONS
Abnormalities of ET metabolism-mainly related to increased synthesis and/or defective pulmonary handling-occur in the acute phase of PE. The relevance of this finding with respect to the pathogenesis and/or management of pulmonary thromboembolism remains to be elucidated.
Sofia
M
M
Department of Thoracic Disease, Federico II University, Naples, Italy.
Faraone
S
S
Alifano
M
M
Micco
A
A
Albisinni
R
R
Maniscalco
M
M
Di Minno
G
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D016232:Endothelins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008168:Lung / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000378:metabolism*; D011863:Radioimmunoassay; D012128:Respiratory Distress Syndrome / Q000097:blood
D016232:Endothelins; D003404:Creatinine