title: Perioperative alterations in plasma endothelin-1 and echocardiographic correlates of right heart function.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York, NY 10021, USA.
authors.forename: D
authors.initials: D
authors.lastname: Amar
authors.forename: M
authors.initials: M
authors.lastname: Fleisher
authors.forename: D H
authors.initials: DH
authors.lastname: Leung
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: I
authors.initials: I
authors.lastname: Ginsburg
authors.forename: N
authors.initials: N
authors.lastname: Roistacher
mesh_terms: 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
chemical_list: D019332:Endothelin-1