Does the plasma endothelin-1 concentration reflect atherosclerosis in the elderly?
OBJECTIVE
Recently, attention has been focused on endothelin-1 (ET-1) as an indicator of atherosclerosis. However, normal levels of ET-1 are frequently found in elderly patients. We investigated the relationships between echocardiographic findings and ET-1 in 117 inpatients for rehabilitation.


METHODS
The patients were 34 men and 83 women, 83.4 +/- 0.8 years old (mean +/- SE), with the following diseases: cerebrovascular diseases (n = 83), cardiovascular diseases of New York Heart Association Class I or II (n = 57), diabetes mellitus (n = 11) and hyperlipidemia (n = 12). Ejection fraction (EF) and left ventricular mass index (LVMI) were calculated by echocardiographic studies.


RESULTS
The average ET-1 was within the normal range, but a significant positive correlation was observed between age and ET-1 (ET-1 = 1.8 +/- 0.1 pg/ml, r = 0. 248, p < 0.01). Moreover, plasma ET-1 was positively correlated to total cholesterol and to low density lipoprotein cholesterol in patients with a history of hypertension (n = 41, r = 0.318 and r = 0. 314, both p < 0.05). Gender was not a significant factor. There was no significant difference in ET-1 between patients with mild renal dysfunction (n = 54) and patients with normal renal function (n = 63) (blood urea nitrogen = 30.9 +/- 2.4 vs. 15.1 +/- 0.5 mg/dl, serum creatinine = 1.03 +/- 0.06 vs. 0.59 +/-0.02 mg/dl, ET-1 = 1.7 +/- 0.1 vs. 1.8 +/- 0.1 pg/ml), or between patients with (n = 50) and without (n = 67) left ventricular hypertrophy (LVMI = 146 +/- 6 vs. 83 +/- 2 g/m(2), ET-1 = 1.8 +/- 0.1 vs. 1.8 +/- 0.1 pg/ml). There was no difference in ET-1 between patients with EF <50% (n = 27) and EF >/=50% (n = 90) (ET-1 = 1.8 +/- 0.2 vs. 1.7 +/- 0.1 pg/ml).


CONCLUSIONS
There were no significant relationships between echocardiographic findings and ET-1 in elderly subjects without overt heart failure. However, in patients with a history of hypertension, measuring ET-1 may be useful for estimating the extent of atherosclerosis.
Sayama
H
H
First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
Nakamura
Y
Y
Saito
N
N
Konoshita
M
M
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D001161:Arteriosclerosis / Q000097:blood* / Q000175:diagnosis; D002561:Cerebrovascular Disorders / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood; D006973:Hypertension / Q000097:blood; D006984:Hypertrophy; D007674:Kidney Diseases / Q000097:blood; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D012727:Sex Characteristics
D008078:Cholesterol, LDL; D019332:Endothelin-1