title: Importance of plasma endothelin-1 level in the evaluation of heart failure severity in infants with ventricular septal defect.
abstract: BACKGROUND
  Haemodynamic disturbances due to ventricular septal defect (VSD) can lead to heart failure (HF) and cause neurohormonal activation. Endothelin-1 (ET-1) clearance takes place mainly in the pulmonary circulation. We hypothesized that increased pulmonary blood flow in children with VSD could influence ET-1 level and reflect haemodynamic disturbances in these patients.
  
  
  OBJECTIVE
  To analyse usefulness of plasma ET-1 level in the evaluation of HF severity in infants with VSD without pulmonary hypertension.
  
  
  METHODS
  The study group included 34 children (aged 38-338 days, mean 130 ± 81 days) with VSD. Evaluation included history, physical examination, ET-1 level measurement, standard 12-lead electrocardiogram, chest X-ray, and transthoracic echocardiography in all children. The control group consisted of 31 healthy children.
  
  
  RESULTS
  Mean plasma ET-1 level was significantly (p < 0.01) higher in the study group compared to the control group. We found no significant difference (p > 0.05) in mean plasma ET-1 level between children with or without HF. No significant correlation was found between plasma ET-1 level and the severity of HF.
  
  
  CONCLUSIONS
  Infants with VSD show higher ET-1 level compared to healthy children. Plasma ET-1 level does not reflect the severity of HF in infants with VSD.
authors.forename: Jacek
authors.initials: J
authors.lastname: Skiendzielewski
authors.affiliation: Department of Paediatric Cardiology and General Paediatrics, Medical University of Warsaw, Warsaw, Poland. bozena.werner@litewska.edu.pl.
authors.forename: Bożena
authors.initials: B
authors.lastname: Werner
mesh_terms: D002675:Child, Preschool; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000097:blood* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index
chemical_list: D019332:Endothelin-1