Perioperative alterations in plasma endothelin-1 and echocardiographic correlates of right heart function.
OBJECTIVE
To determine whether greater changes in plasma endothelin-1 (ET-1) concentrations and right ventricular systolic pressure occur after major thoracic surgery than after major abdominal operations.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Patients undergoing elective thoracotomies (n = 12) or laparotomies (n = 10).


METHODS
ET-1 was measured from blood obtained before anesthesia and again on postoperative days 1, 2, 3, and 5 (or 6). Transthoracic echocardiography was performed before surgery and on postoperative day 2 to evaluate right-sided heart function.


RESULTS
After abdominal and thoracic surgery, systemic and estimated pulmonary vascular pressures were normal in both groups and unaffected by surgery. Plasma ET-1 concentrations decreased from baseline values during the first postoperative week with no differences between the groups.


CONCLUSIONS
In patients without organic heart disease, plasma ET-1 levels do not increase in response to major abdominal or thoracic surgery. Whether or not plasma ET-1 concentrations are elevated in patients developing clinically significant postoperative pulmonary hypertension requires further study.
Amar
D
D
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY 10021, USA.
Fleisher
M
M
Leung
D H
DH
Zhang
H
H
Ginsburg
I
I
Roistacher
N
N
D000368:Aged; D000758:Anesthesia; D001794:Blood Pressure / Q000502:physiology; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006321:Heart / Q000502:physiology*; D006334:Heart Function Tests; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011652:Pulmonary Circulation / Q000502:physiology; D011863:Radioimmunoassay; D013908:Thoracotomy
D019332:Endothelin-1