The relationship between urotensin II plasma immunoreactivity and left ventricular filling pressures in coronary artery disease.
The role of urotensin II (U-II)--a vasoactive, mitogenic, and inotropic, peptide--in the pathophysiology of heart failure is controversial. The present study explores the relationship between plasma U-II immunoreactivity (U-IIIR) and hemodynamics in patients with coronary artery disease (CAD). Thirty-six patients with CAD-3 undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) and 36 medical patients (MED group) with CAD-1 to CAD-3 during right heart catheterization were studied. Significant correlations were observed between pulmonary capillary wedge pressure (PCWP) and U-IIIR--determined by enzyme immunoassay (EIA)--before (rho = 0.83) and after (rho = 0.6) cardiopulmonary bypass in the CABG group. With the exception of the CPB period, CABG patients with increased PCWP before CPB had higher U-II(IR) concentrations throughout the procedure. Significant correlations were observed between U-IIIR, proANP, proBNP, and mean right ventricular pressure (RVPM) in MED patients. No correlation was detectable between U-IIIR and PCWP. However, MED patients with CAD-3 (n = 13) had higher levels of U-IIIR, NTproANPIR (RIA), NTproBNPIR (EIA) and higher cardiac filling pressures than patients with CAD-1 (n = 13). These findings support an association between plasma U-IIIR levels and diastolic myocardial dysfunction in ischemic heart failure. The discrepancies regarding left and right cardiac filling pressures and U-IIIR levels in CABG and MED patients require further evaluation.
Heringlake
Matthias
M
Klinik für Anaesthesiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany. Heringlake@t-online.de
Kox
Thomas
T
Uzun
Orhan
O
Will
Barbara
B
Bahlmann
Ludger
L
Klaus
Stephan
S
Eleftheriadis
Sawas
S
Armbruster
Franz Paul
FP
Franz
Norbert
N
Kraatz
Ernst
E
D000368:Aged; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D014579:Urotensins / Q000097:blood* / Q000276:immunology*; D017725:Ventricular Pressure / Q000502:physiology*
D014579:Urotensins; C029677:urotensin II