Chest
Original Research: Pulmonary HypertensionEndothelin-1/Endothelin-3 Ratio: A Potential Prognostic Factor of Pulmonary Arterial Hypertension
Section snippets
Subjects
Thirty-three subjects with PAH were included in this study from three different previous studies15, 16, 17and were enrolled consecutively during three different time periods between February 1994 and April 1998. Institutional Review Board approval was obtained for these studies, and all patients gave informed consent for these studies and for additional biological studies.15, 16, 17PAH was defined by mean pulmonary arterial pressure (mPAP) > 25 mm Hg with normal pulmonary capillary wedge
Characteristics of Subjects
Thirty-three patients with PAH were included in this study, 19 of them with idiopathic PAH, 1 with familial PAH, 6 with appetite suppressant-associated PAH, and 7 with PAH associated with other conditions (portopulmonary hypertension, n = 3; HIV infection-associated PAH, n = 1; systemic sclerosis-associated PAH, n = 2; pulmonary venoocclusive disease, n = 1). At the time of blood sampling for ET plasma concentration measurement, none of these patients had been previously treated with specific
Discussion
In this study, we have demonstrated that PAH is characterized by an imbalance of ET plasma concentrations, with an increase of ET-1 and a decrease of ET-3 plasma concentrations in comparison with control subjects. We have demonstrated that ET-1/ET-3 ratio was well correlated with many clinical and hemodynamic prognostic factors in PAH and that the presence of an increased ET-1/ET-3 ratio was associated with worse prognosis in this sample of PAH patients.
As previously described, we have found
Acknowledgments
We thank Virginie Sippel for expert technical performance in the measurement of ET-1 and ET-3; Olivier Sitbon (Service de Pneumologie et Réanimation respiratoire, Hôpital Antoine-Béclère, Clamart, France) for helpful comments during the preparation of this article; and Frederic Perros for technical support.
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2020, Pathology Research and PracticeCitation Excerpt :The underlying mechanisms that are responsible for regulation of vascular tone in the pulmonary circulation are complex, and involve multiple factors such as the dispensability of the pulmonary vasculature, the function of the heart, concentration of oxygen in the blood and the capacity of the endothelium to release vasoactive substances [29]. Studies have found high levels of ET-1 in PH patients [19] and after exposure to cigarette smoke [21], hypoxic-induced PH rats exhibit an elevated ET-1 level in plasma and increased gene expressions for ETA and ETB receptors in lung tissue [30]. The observations that both ET-1 and its receptors are up-regulated in response to hypoxia suggest that ET-1 is a key mediator in the development of hypoxia-induced PH, which are further supported by findings that hypoxic pulmonary vasoconstriction and vascular remodeling can be prevented and reversed by administration of either ETA selective or combined ETA and ETB receptor antagonists [31].
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An abstract of this work was presented at the 2005 European Respiratory Society Meeting, Copenhagen, Denmark, September 17–21, 2005.
Support was provided by the European Respiratory Society, Fellowship No. 192.
The authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestjournal.org/misc/reprints.shtml).