Pulmonary and Systemic Responses to Exogenous Endothelin-1 in Patients with Left Ventricular Dysfunction

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Abstract
Plasma levels of immunoreactive endothelin-1 (ET-1) are elevated in chronic heart failure(CHF) and have been reported to correlate closely with pulmonary hemodynamic measurements. We investigated the effects of exogenous ET-1 on the pulmonary vasculature in patients with left ventricular systolic dysfunction (LVD), with or without overt heart failure. ET-1 was infused at 1, 5, and 15 pmol/min into a distal pulmonary artery of 10 patients with LVD. Hemodynamics were measured by a thermodilution catheter and arterial line. Intravascular Doppler and local pulmonary angiography were used to assess local pulmonary blood flow in the first four patients. Systemic hemodynamic changes occurred with ET-1 infusion in a dose-dependent fashion. Mean arterial pressure (100 ± 8-107± 11 mm Hg; p −5