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Big endothelin-1 as a clinical marker for ventricular tachyarrhythmias in post-infarction left ventricular aneurysm patients [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-67862 | DOI: 10.14744/AnatolJCardiol.2019.67862  

Big endothelin-1 as a clinical marker for ventricular tachyarrhythmias in post-infarction left ventricular aneurysm patients

Xiaohui Ning1, Zihe Yang2, Xuerui Ye1, Yanhua Si1, Fang Wang1, Xiaoli Zhang2, Shu Zhang1
1State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
2Department of Nuclear Medicine, Anzhen Hospital

Objectives
Ventricular tachyarrhythmia is the leading cause of death in post-infarction patients. Big endothelin-1 (ET-1) is a potent vasoconstrictor peptide and plays a role in ventricular tachyarrhythmia development. The aim of this study was to investigate the association between big ET-1 concentrations and prevalent ventricular tachyarrhythmia in post-infarction left ventricular aneurysm (PI-LVA) patients.
Methods
A total of 222 consecutive PI-LVA patients who received medical therapy were enrolled. There were 43 (19%) patients who had ventricular tachycardia/ventricular fibrillation (VT/VF) at admission. The clinical characteristics were collected, and the plasma big ET-1 level was measured. Associations between big ET-1 and the presence of VT/VF were assessed. Patients were followed up for outcomes including cardiovascular mortality, VT/VF attack and all-cause mortality.
Results
The median concentration of big ET-1 was 0.635 pg/ml. Patients with big ET-1 concentrations above the median were more likely to have higher-risk clinical features. There was a positive correlation of the big ET-1 level with VT/VF (r = 0.354, P<0.001). In the multiple logistic regression analysis, big ET-1 (OR=4.06, 95% CI 1.779.28, P<0.001) appeared as an independent predictive factor of the presence of VT/VF. Multiple Cox regression analysis suggested that big ET-1 concentration was independently predictive of VT/VF attack (OR=2.5, 95% CI 1.4-4.5, P<0.001). NT-proBNP and LVEF≤35% were demonstrated to be independently predictive of cardiovascular mortality and all-cause mortality.
Conclusions
Increased big ET-1 concentration in PI-LVA patients was a valuable independent predictor for the presence of ventricular tachyarrhythmia and VT/VF attack during follow-up.

Keywords: Big endothelin-1, ventricular tachyarrhythmia, post-infarction left ventricular aneurysm




Corresponding Author: Shu Zhang, China


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