Elevated Endothelin with Pulmonary Hypertension Raises Mortality Risk
Elevated plasma endothelin-1 levels are associated with an increased risk of heart failure and death in individuals with pulmonary hypertension and could be used to help identify a population for targeted prevention, according to a recent study.
While the links between endothelin-1 and pulmonary vascular remodeling have been observed in the past, little data are available on the relationship between plasma endothelin-1 and pulmonary hypertension and whether endothelin-1 could potentially predict the risk of heart failure.
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For their study, the researchers collected data from the Jackson Heart Study, a longitudinal, prospective, observational cohort study of heart disease in African Americans from Jackson, Mississippi. Participants (N = 3223) all had plasma endothelin-1 levels and tricuspid regurgitation on echocardiogram at first examination.
Mean endothelin-1 levels were 1.36 (0.64) pg/mL and 217 of the participants had pulmonary hypertension. Overall, endothelin-1 levels were associated with increased risk of pulmonary hypertension, mortality, and heart failure. Those with both pulmonary hypertension and high endothelin-1 levels saw the highest risk of mortality, while those with low endothelin-1 levels and no pulmonary hypertension had the lowest risk.
“Elevated plasma endothelin levels, especially associated with an elevated pulmonary artery systolic pressure on echocardiogram, identify an at-risk population that could be evaluated for targeted prevention and management strategies in future studies,” the researchers concluded.
—Michael Potts
Reference:
Jankowich MD, Wu W-C, Choudhary G. Association of elevated plasma endothelin-1 levels with pulmonary hypertension, mortality, and heart failure in African American individuals [published online June 8, 2016]. JAMA Cardiol. doi:10.1001/jamacardio.2016.0962.