Arterial endothelin-1 level in pulmonary emphysema and interstitial lung disease. Relation with pulmonary hypertension during exercise

• Published in: The European respiratory journal Vol. 10; no. 9; pp. 2055 - 2060
• Main Authors: Yamakami, T, Taguchi, O, Gabazza, EC, Yoshida, M, Kobayashi, T, Kobayashi, H, Yasui, H, Ibata, H, Adachi, Y
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01.09.1997; Maney
• Subjects: Aged; Biological and medical sciences; Carbon Dioxide - blood; Endothelin-1 - blood; Female; Humans; Hypertension, Pulmonary - blood; Hypertension, Pulmonary - etiology; Lung Diseases, Interstitial - blood; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - physiopathology; Male; Medical sciences; Middle Aged; Oxygen - blood; Physical Exertion; Pneumology; Pulmonary Emphysema - blood; Pulmonary Emphysema - complications; Pulmonary Emphysema - physiopathology; Respiratory system : syndromes and miscellaneous diseases; Rest; Physical exercise; Human; Lung disease; Respiratory disease; Exploration; Endothelin 1; Blood plasma; Assay; Pulmonary vessel; Interstitial pneumonitis; Bronchus disease; Circulatory system; Obstructive pulmonary disease; Hemodynamics; Emphysema
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.97.10092055

This study was undertaken to assess the arterial plasma levels of endothelin-1 (ET-1) and their relationship with pulmonary haemodynamic and gas exchange variables during exercise in patients with emphysema and interstitial lung disease (ILD). Incremental cycle ergometry was performed in all patients up to maximal capacity. At rest, arterial ET-1 levels were higher in emphysema (1.86 +/- 0.35 pg.mL-1; p < 0.02) and ILD (1.75 +/- 0.25 pg.mL-1; p < 0.03) patients than in controls (1.35 +/- 0.18 pg.mL-1). Emphysema (2.08 +/- 0.26 versus 1.70 +/- 0.40 pg.mL-1) and ILD (1.98 +/- 0.21 versus 1.67 +/- 0.02 pg.mL-1) patients with pulmonary hypertension (PH) presented significantly (p < 0.05) higher arterial ET-1 levels than those without. At rest, arterial ET-1 levels were significantly correlated with mean pulmonary arterial pressure (Ppa) in both ILD (r = 0.8, p = 0.01) and emphysema (r = 0.5, p = 0.03) patients. During exercise, the arterial ET-1 levels were significantly correlated with arterial oxygen (Pa,O2) (r = -0.6, p = 0.04), alveolar-arterial oxygen difference (r = 0.8, p = 0.01), and Ppa (r = 0.6, p = 0.04) in ILD patients, but not in those with emphysema. In brief, the results of this study suggest that arterial endothelin-1 is markedly increased in interstitial lung disease and emphysema patients, and that, it is related to the exercise-induced exacerbation of pulmonary hypertension in patients with interstitial lung disease, but not in those with emphysema.