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Is the pregnancy hormone relaxin an important player in human heart failure?
Author(s) -
Kupari Markku,
Mikkola Tomi S.,
Turto Heikki,
Lommi Jyri
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.07.010
Subject(s) - relaxin , medicine , heart failure , cardiology , ejection fraction , coronary sinus , blood pressure , pulmonary wedge pressure , diastole , endocrinology , hormone
Background: The pregnancy hormone relaxin has been raised as a new compensatory mediator of cardiac origin in heart failure (HF). We set out to assess the role of relaxin in pressure overload‐induced human HF. Methods: We studied 129 adult patients undergoing cardiac catheterization for isolated aortic valve stenosis (AS). Blood was sampled from the aortic root and, in a subset of 49 patients, from the coronary sinus for the determination of plasma relaxin by enzyme immunoassay. HF was diagnosed when the patient had dyspnea or fatigue on ordinary effort in association with pulmonary wedge pressure >14 mm Hg at catheterization. Results: Forty‐one patients had HF, which was systolic (ejection fraction <50%) in 16 patients and diastolic in 25 patients. The median plasma relaxin was 32 pg/ml (<12−297 pg/ml) in 88 AS patients without HF, 28 pg/ml (<12−825 pg/ml) in the 41 AS patients with HF, and 42 pg/ml (range, <12−100 pg/ml) in 11 control patients free of heart disease ( p =0.82). Plasma relaxin did not correlate with any measurement of cardiac structure or function. The concentration gradients of relaxin from the aortic root to the coronary sinus indicated relaxin extraction by the heart in the control patients (median change, −5 pg/ml, p =0.038) vs. relaxin production in patients with systolic HF (median change, +6 pg/ml, p =0.028) ( p =0.002 between groups). Conclusions: Although the heart may release relaxin into the circulation in certain forms of HF, this does not translate into elevated systemic concentrations. Relaxin is not a major player in human HF.