PMID- 15599839
OWN - NLM
STAT- MEDLINE
DCOM- 20050407
LR  - 20191109
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 10
IP  - 6
DP  - 2004 Dec
TI  - Superiority of big endothelin-1 and endothelin-1 over natriuretic peptides in 
      predicting survival in severe congestive heart failure: a 7-year follow-up study.
PG  - 490-5
AB  - BACKGROUND: Plasma concentrations of atrial and brain natriuretic peptides (ANP, 
      BNP), of their N-terminal pro-peptides, of endothelin-1 (ET-1), and big 
      endothelin-1 (big ET-1) have diagnostic and prognostic significance in congestive 
      heart failure (CHF). However, their respective values as a predictor of survival 
      remain controversial and have never been directly compared in severe CHF. METHODS 
      AND RESULTS: We analyzed, in 47 patients with severe CHF (New York Heart 
      Association [NYHA] class III to IV; age 66 +/- 8 years, ejection fraction 20 +/- 
      6%), the prognostic performance of a panel of neurohormones and assays 
      (N-terminal pro-ANP 1-25, 68-98 by radioimmunoassay [RIA], and 1-98 by 
      enzyme-linked immunosorbent assay [ELISA], BNP by RIA and immunoradiometric assay 
      [IRMA], N-terminal pro-BNP by Elisa, ET-1 by RIA, and big ET-1 by RIA and Elisa. 
      Data were compared with 40 patients with mild to moderate CHF [NYHA I-II] and 30 
      healthy subjects. After a follow-up of 81 +/- 15 months, there were 34 deaths and 
      1 heart transplant. All neurohormones were significantly higher at baseline in 
      patients with severe than in mild to moderate CHF or healthy subjects (all P < 
      .001). Although all neurohormones but BNP IRMA were significant predictors of 
      survival in univariate analysis, only big ET-1 RIA and ET-1 were independent 
      predictors of survival (improvement chi(2): 7.5 and 4.6, P < .01 and P < .05). 
      Using medians as cutpoints of big ET-1 RIA and ET-1, 2 severe CHF populations 
      were defined with a different outcome (5-year survival: 55 versus 18%, P < .01). 
      CONCLUSIONS: Big ET-1 and ET-1 are strong independent predictors of survival in 
      patients with severe CHF and better for this purpose than natriuretic peptides or 
      their pro-peptides. These markers allow easily to identify a population with a 
      very high risk mortality eligible for more aggressive therapies.
FAU - Van Beneden, Ronald
AU  - Van Beneden R
AD  - Diabetes and Nutrition Unit, Division of Cardiology, School of Public Health, 
      University of Louvain, B-1200 Brussels, Belgium.
FAU - Gurne, Olivier
AU  - Gurne O
FAU - Selvais, Philippe L
AU  - Selvais PL
FAU - Ahn, Sylvie A
AU  - Ahn SA
FAU - Robert, Annie R
AU  - Robert AR
FAU - Ketelslegers, Jean-Marie
AU  - Ketelslegers JM
FAU - Pouleur, Hubert G
AU  - Pouleur HG
FAU - Rousseau, Michel F
AU  - Rousseau MF
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Endothelin-1)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Atrial Natriuretic Factor/*blood
MH  - Endothelin-1/*blood
MH  - Female
MH  - Heart Failure/*blood/*mortality
MH  - Humans
MH  - Immunoradiometric Assay
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Prognosis
EDAT- 2004/12/16 09:00
MHDA- 2005/04/09 09:00
CRDT- 2004/12/16 09:00
PHST- 2004/12/16 09:00 [pubmed]
PHST- 2005/04/09 09:00 [medline]
PHST- 2004/12/16 09:00 [entrez]
AID - S107191640400096X [pii]
AID - 10.1016/j.cardfail.2004.04.001 [doi]
PST - ppublish
SO  - J Card Fail. 2004 Dec;10(6):490-5. doi: 10.1016/j.cardfail.2004.04.001.