title: Systemic levels of endothelin correlate with systemic inflammation and not with myocardial injury or left ventricular ejection fraction in patients undergoing percutaneous coronary intervention and on-pump coronary artery bypass grafting.
abstract: Endothelin (ET-1) is a potent vasoconstrictor. We compared patterns of ET-1 in percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and correlated it with markers of inflammation. Patients with multivessel disease were enrolled in a prospective randomized study of PCI vs. on-pump CABG. Procedural myocardial injury was assessed biochemically (CK-MB) and with new late gadolinium enhancement (LGE) on magnetic resonance imaging (MRI) one week postprocedure. ET-1 was measured at baseline, 1 h, 6 h, 12 h, 24 h and one week postprocedure. Log ET-1 values were compared between PCI and CABG and between patients without significant myocardial injury. Measurement of ET-1 values was performed in 36 PCI and 31 CABG patients. Baseline ET-1 values were similar between PCI and CABG patients (0.91 ± 0.36 vs. 1.0 ± 49 pg/ml, P = 0.38). Peak values were reached at 1 h in PCI and at 24 h in CABG patients and patients undergoing CABG had significantly higher log ET-1 values at 6 h, 12 h and 24 h. ET-1 did not correlate with biochemical or morphological markers of myocardial injury or change of left ventricular ejection fraction (LV-EF) but good linear correlation between max logET-1 and max logCRP was found (r = 0.44, P = 0.0002). ET-1 rise is more pronounced in on-pump CABG and ET-1 production could be driven by periprocedural inflammatory reaction.
authors: Oxford Heart Centre, John Radcliffe Hospital, Oxford OX3 9DU,  UK.
authors: Florim
authors: F
authors: Cuculi
authors: Chris C S
authors: CC
authors: Lim
authors: William
authors: W
authors: van Gaal
authors: Luca
authors: L
authors: Testa
authors: Stephen
authors: S
authors: Westaby
authors: Jayanth R
authors: JR
authors: Arnold
authors: Stefan
authors: S
authors: Neubauer
authors: Adrian P
authors: AP
authors: Banning
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003287:Contrast Media; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D052279:Creatine Kinase, MB Form / Q000097:blood; D019332:Endothelin-1 / Q000097:blood*; D004739:England; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D019332:Endothelin-1; D018836:Inflammation Mediators; D019210:Troponin I; D052279:Creatine Kinase, MB Form