title: Elevated level of plasma endothelin-1 in patients with atrial septal defect.
abstract: BACKGROUND
  The study aimed to assess the level of plasma Endothelin-1 (ET-1) in patients before and after transcatheter closure of atrial septal defect (ASD) and to evaluate the usefulness of measuring ET-1 levels for the diagnosis and selection of candidates for ASD closure.
  
  
  METHODS
  80 patients (55 F, 25 M), mean age 42,2 ± 11,5 years were enrolled for an attempt at ASD closure. A group of 19 healthy volunteers, (12 F, 7 M) mean age 39.2 ± 9.15 served as controls. All ASD patients underwent: clinical and echocardiographic study and cardiopulmonary exercise test. ET-1 levels were measured before and after closure. Whole blood was collected from femoral artery and vein and from pulmonary artery during cardiac catheterization.
  
  
  RESULTS
  ET-1 levels at peripheral artery and vein in ASD patients were significantly higher than in the volunteers (p < 0.0001). The ASD subjects with highest ET-1 level presented the larger area of right ventricle and right atrium and higher pulmonary artery systolic pressure(p < 0.05). The ASD subjects with lower ET-1 level demonstrated longer time of exercise and higher peak oxygen consumption (p < 0.05). There was a decrease of ET-1 at peripheral artery (5.128 ± 8.8 vs. 2.22 ± 6.2; p < 0.001) and at peripheral vein (4.401 ± 3.33 vs. 2.05 ± 1.35; p < 0.001) within 48 hours after ASD closure, as compared to the baseline data. After 6 and 12 months farther drop in ET-1 level was observed.
  
  
  CONCLUSIONS
  1. The level of ET-1 in ASD patients is elevated in compare to healthy subject.2. The significant reduction of ET-1 level is observed after percutaneous closure of ASD.3. Elevated level of ET-1 in patients with ASD is associated with right heart enlargement.4. Measurements of ET-1 may be a supplemental diagnostic tool and may be helpful in establishing indications for defect closure.
authors.affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Institute of Cardiology, Jagiellonian University, Str, Prądnicka 80, 31-202 Krakow, Poland. moni_s@interia.pl.
authors.forename: Monika
authors.initials: M
authors.lastname: Komar
authors.forename: Jakub
authors.initials: J
authors.lastname: Podolec
authors.forename: Wojciech
authors.initials: W
authors.lastname: Płazak
authors.forename: Jakub
authors.initials: J
authors.lastname: Stępniewski
authors.forename: Bartosz
authors.initials: B
authors.lastname: Sobień
authors.forename: Lidia
authors.initials: L
authors.lastname: Tomkiewicz-Pająk
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Przewłocki
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D013504:Cardiovascular Surgical Procedures; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019332:Endothelin-1
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