Neurohormonal activation in patients with right ventricular failure from pulmonary hypertension: Relation to hemodynamic variables and endothelin levels

Mark Nootens, Elizabeth Kaufmann, Thomas Rector, Cynthia Toher, Dianne Judd, Gary S. Francis, Stuart Rich*

*Corresponding author for this work

Research output: Contribution to journalArticle

244 Scopus citations

Abstract

Objectives.: This study sought to determine whether neurohormonal activation occurs in isolated right heart failure. Background.: Neurohormonal activation appears to parallel the severity of left heart failure, but little is known about its role in right heart failure. Methods.: We evaluated neurohormonal activation and endothelin levels in 21 patients with primary pulmonary hypertension at the time of right heart catheterization. Results.: Plasma norepinephrine levels correlated significantly with pulmonary artery pressure (r = 0.66, p < 0.01), cardiac index (r = -0.56, p < 0.01) and pulmonary vascular resistance (r = 0.69, p < 0.001). Atrial natriuretic peptide levels were higher in the pulmonary artery than the right atrium and femoral artery and correlated closely with pulmonary artery oxygen saturation (r = -0. 73, p < 0.0001). Plasma renin levels were not elevated. Endothelin levels were increased and correlated with right atrial pressure (r = 0.74, p < 0.0001) and pulmonary artery oxygen saturation (r = -0.070, p < 0.0004). Conclusions.: Neurohormonal activation occurs in patients with isolated right ventricular failure and inherently normal left ventricles and appears to be related to the overall severity of cardiopulmonary derangements. The elevation in endothelin levels is consistent with its release in response to pulmonary hypertension.

Original languageEnglish (US)
Pages (from-to)1581-1585
Number of pages5
JournalJournal of the American College of Cardiology
Volume26
Issue number7
DOIs
StatePublished - Dec 1995

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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