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Acute hemodynamic and neurohumoral effects of selective ET_A receptor blockade in patients with congestive heart failure

Lukas E. Spieker, MD^a, Veselin Mitrovic, MD^*, Georg Noll, MD, FESC^a, Richard Pacher, MD, Matthias R. Schulze, MD, J.örg Muntwyler, MD, MPH^a, Christoph Schalcher, MD^a, Wolfgang Kiowski, MD, FACC, FESC^a, Thomas F. Lüscher, MD, FACC, FRCP, FESC^a on behalf of the ET 003 Investigators

^a Division of Cardiology, University Hospital, Zürich, Switzerland
^* Kerckhoff Clinic, Bad Nauheim, Germany
Allgemeines Krankenhaus, Wien, Austria
Herz-und Kreislaufzentrum, Cardiology, Dresden, Germany

View larger version (16K): [in a new window]   Figure 1 Correlations between baseline endothelin (ET)-1 plasma levels and hemodynamic parameters in patients with chronic heart failure (n = 91). Mean pulmonary artery (MPAP, mm Hg; top) and pulmonary capillary wedge pressure (PCWP, mm Hg; middle) correlated positively with ET-1 plasma levels, while cardiac index (ml·min–1·m–2; bottom) was inversely associated with ET-1 levels.

View larger version (23K): [in a new window]   Figure 2 Changes of cardiac index and systemic vascular resistance 4 h after administration of different dosages of LU135252, a selective ETA receptor antagonist. *p < 0.05; **p 0.0002.

View larger version (21K): [in a new window]   Figure 3 Changes of endothelin-1 plasma levels after administration of various dosages of the selective ETA receptor antagonist LU135252. There was a dose-dependent increase in plasma ET-1 levels. *p < 0.003 vs. baseline.