The relation between endothelin-1 levels and myocardial injury in chronic ischemic heart failure.

We evaluated whether there was any relation between myocardial injury and endothelin-1 (ET-1) levels, which has been suggested as a contributor to the progression of ischemic heart failure. One hundred and twenty-one patients with chronic ischemic heart failure and 37 healthy individuals were included in the study. Cardiac troponin-I (cTn-I) and ET-1 levels of all subjects were measured on admission. Echocardiographic evaluations were also performed. The positivity of cTn-I increased significantly as the severity changed from New York Heart Association (NHYA) Class I to IV (P < 0.01). This was also true for quantitative cTn-I levels (P < 0.05). The ET-1 levels of patients were higher than controls on admission (P < 0.001). The ET-1 levels increased significantly upon the progression from NHYA Class I to IV (P < 0.001). Moreover, patients with cTn-I positivity had higher ET-1 levels (P < 0.05) and a lower ejection fraction (P < 0.001). A negative correlation was found between ejection fraction and the ET-1 levels (r = -0.312, P = 0.019). In patients with cTn-I positivity, the cTn-I levels showed a positive correlation with the ET-1 levels (r = 0.328, P = 0.014) and a negative correlation with ejection fraction (r = -0.671, P < 0.001). In chronic ischemic heart failure, an increase in ET-1 may exert an influence on the progression of cardiac failure by leading to myocardial injury which may be demonstrated by higher cTn-I levels.