Plasma Endothelin-1 Levels in Septic Patients

Abstract

Dysfunction of the vascular endothelium (ET) causes an increase in serum ET-1 concentration, as observed in septic patients. It was assumed that in this patient population the ET-1 level correlates with the degree of sepsis severity, including the level of organ dysfunction and, in particular, the level of circulatory dysfunction. The aim of the present study was to assess the relationship between levels of ET-1 and levels of N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT), and C-reactive protein (CRP), as well as the Sepsis-related Organ Failure Assessment (SOFA) score in septic patients. PCT and CRP were used to estimate the level of sepsis severity; the SOFA score was used to estimate multiorgan dysfunction; and NT-proBNP was used as a marker of cardiac dysfunction. Twenty patients with sepsis and severe sepsis were included in the study. Blood serum ET-1, NT-proBNP, PCT, and CRP concentrations were determined at specific time intervals, and the SOFA score was calculated. Mean ET-1, NT-proBNP, PCT, and CRP concentrations were 8.39 pg/ml +/- 6.39 pg/mL, 140.80 pg/mL +/- 84.65 pg/mL, 22.32 ng/mL +/- 97.41 ng/mL, and 128.51 mg/L +/- 79.05 mg/L, respectively. Correlation between ET-1 levels and levels of NT-proBNP, PCT, and CRP was .3879 (P < .001), .358 (P < .001), and .225 (P = .011), respectively. Mean SOFA score was 6.31 pts +/- 3.75 pts. Correlation between the ET-1 levels and SOFA score was .470 (P < .001). Six patients (30%) died during the observation period of 28 days. ET-1 levels correlate with levels of NT-proBNP, PCT, and CRP, as well as the SOFA score in septic patients.

Adrenomedullin and endothelin-1 are related to inflammation in chronic heart failure

“…In the adjusted model (Table 4), the ET-1 level was associated with the serum concentration of IL-6, TNF-Rs and CRP independently from disease severity (NYHA classes, BNP) and clinical parameters. Similar observations on the correlation between ET-1 and CRP were made in septic patients [31], and modest correlation was found between TNF-alpha and bigET-1 in CHF [32]. In the heart, ET-1 may induce myocardial inflammation by recruiting leukocytes, stimulating production of adhesion molecules, and inducing cytokine expression, like IL-6, TNF-alpha, IL-1.…”

Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis?

“…Correlation between ET-1 levels and levels of NT-proBNP, PCT, and CRP was 0.3879 (p < 0.001), 0.358 (p < 0.001), and 0.225 (p = 0.011), respectively. Correlation between the ET-1 levels and SOFA score was 0.470 (p < 0.001) (Piechota et al 2007).…”

Endothelin-1 and its role in the pathogenesis of infectious diseases

“…However, there is a consensus that the increase in plasma levels of ET-1 in the setting of sepsis is mainly due to endothelial cell damage. The plasma levels of ET-1 in the setting of severe sepsis in adults and neonates are significantly increased and correlate with renal and myocardial dysfunction [50, 55, 133-135]. The ET-1 levels correlate with Sepsis-related Organ Failure Assessment (SOFA) scores and correlate with other parameters of severe sepsis such as C-reactive protein, procalcitonin and natriuretic propeptide (NT-proBNP) [55].…”

“…ET-1 is associated with vasospasms, vascular damage, blood brain barrier (BBB) permeability, cardiovascular remodeling, and inflammation [19, 20, 46, 53, 54]. Septic patients have increased ET-1 plasma concentrations, which correlate with renal dysfunction and disease severity [55]. Levels of cerebral spinal fluid (CSF) ET-1 are significantly elevated in individuals with bacterial meningitis, which is associated with abnormalities in cerebral blood flow (CBF) [49].…”