The role of endothelial dysfunction in the development of postinfarction heart failure

Heart failure has remained completely unresolved problem yet. Coronary artery disease (CAD) has been considered as the most common cause of heart failure. Endothelial dysfunction has been regarded as an important factor involved in the development of cardiovascular diseases, and plasma endothlin-1 levels as their prognostic and severity marker. The purpose of the present study was elucidation of the role of endothelial dysfunction in the development of postinfarction heart failure. A total of 63 patients with heart failure of I-IV (NYHA) functional classes were observed. Each of these groups was divided into two subgroups. First subgroup included patients who had myocardial infarction not later than 6 weeks. Second subgroup was represented by patients with non-ischemic heart failure caused by acquired and congenital valvular heart diseases, dilated cardiomyopathy. Endothelial dysfunction occurs at the early stages (I-II) postinfarction heart failure. Plasma levels of ET-1 was significantly increased in postinfarction sub-group (75,58±5,99 pg/ml) compared to control group (52,60±3,87 pg/ml) and non-ischemic sub-group (58,13±2,5 pg/ml) (p<0,01). Positive correlation was found between ET-1 plasma levels and severity of heart failure that did not depend on the genesis of cardiac insufficiency