The relationship between urotensin II plasma immunoreactivity and left ventricular filling pressures in coronary artery disease

The role of urotensin II (U-II)—a vasoactive, mitogenic, and inotropic, peptide—in the pathophysiology of heart failure is controversial. The present study explores the relationship between plasma U-II immunoreactivity (U-II IR) and hemodynamics in patients with coronary artery disease (CAD). Thirty-six patients with CAD-3 undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) and 36 medical patients (MED group) with CAD-1 to CAD-3 during right heart catheterization were studied. Significant correlations were observed between pulmonary capillary wedge pressure (PCWP) and U-II IR—determined by enzyme immunoassay (EIA)—before (rho=0.83) and after (rho=0.6) cardiopulmonary bypass in the CABG group. With the exception of the CPB period, CABG patients with increased PCWP before CPB had higher U-II IR concentrations throughout the procedure. Significant correlations were observed between U-II IR, proANP, proBNP, and mean right ventricular pressure (RVPM) in MED patients. No correlation was detectable between U-II IR and PCWP. However, MED patients with CAD-3 ( n=13) had higher levels of U-II IR, NTproANP IR (RIA), NTproBNP IR (EIA) and higher cardiac filling pressures than patients with CAD-1 ( n=13). These findings support an association between plasma U-II IR levels and diastolic myocardial dysfunction in ischemic heart failure. The discrepancies regarding left and right cardiac filling pressures and U-II IR levels in CABG and MED patients require further evaluation.