Effects of implantable cardioverter defibrillator implantation and shock application on serum endothelin-1 and big-endothelin levels

Szűcs, Andrea and Keltai, Katalin and Zima, Endre István and Vágó, Hajnalka and Soós, Pál and Róka, Attila and Szabolcs, Zoltán and Gellér, László Alajos and Merkely, Béla Péter (2002) Effects of implantable cardioverter defibrillator implantation and shock application on serum endothelin-1 and big-endothelin levels. CLINICAL SCIENCE, 103 (S48). 233S-236S. ISSN 0143-5221

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Abstract

The incidence of ventricular tachyarrhythmias in the early post-operative period following implantable cardioverter-defibrillator (ICD) implantation is relatively high compared with that in control periods. Since endothelin-1 (ET-1) has been proven to be an endogenous arrhythmogenic substance, we investigated the changes in serum ET-1 and big-ET levels in patients undergoing ICD implantation. Serum concentrations of ET-1 and big-ET were measured in 14 patients with various heart diseases before the operation, as well as 1 min and 1 h after the last shock therapy. Big-ET levels and the sum of ET-1 and big-ET levels were unchanged immediately after the operation, but had increased significantly by 1 h after implantation (before, 1.57+/-0.61 pmol/l; 1 min, 1.86+/-0.87 pmol/l; 1 h, 4.29+/-1.65 pmol/l for big-ET; before, 3.44+/-1.07 pmol/l; 1 min, 3.79+/-1.29 pmol/l; 1 h, 6.36+/-2.03 pmol/l for big-ET+ET-1). There was a significant correlation between left ventricular ejection fraction and big-ET level measured 1 h after the last shock delivery (r=-0.542, P<0.05). We conclude that the increased big-ET level observed 1 h after the last induction and shock therapy of ventricular fibrillation might have a pathophysiological role in the increased incidence of post-operative spontaneous ventricular arrhythmias.

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