Elevated Endothelin-1 Level In Urine Linked To Early Phase Heart Disease

Increased levels of endothelin-1 can be detected earlier in the urine than in the plasma of heart disease patients and are closely correlated with sodium excretion.

These findings support the use of endothelin-1 antagonists in patients with heart failure, researchers suggest.

Earlier studies found significant increases in plasma endothelin-1 levels in heart failure patients, but urinary excretion of endothelin-1 had not been investigated.

Previous studies also suggested that endothelin-1 antagonists might help improve renal blood flow and increase the excretion of sodium in experimental heart failure.

In this study, published in American Heart Journal, investigators divided 147 heart failure patients into groups according to the New York Heart Association (NYHA) functional classes. Plasma and urinary endothelin-1 levels were measured in these patients and in 28 healthy controls.

Investigators also measured atrial and brain natriuretic peptide, arginine vasopressin, plasma renin activity and hemodynamic variables.

Results showed that increased levels of urinary endothelin-1 were already detectable in NYHA class II patients, while increases in plasma endothelin-1 were not detected before NYHA class III and IV.

Multivariate analysis revealed that urinary endothelin-1 was the strongest predictor of sodium excretion in 71 patients who were not receiving diuretics.