{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:40:53Z","timestamp":1792460453346,"version":"4.5.0"},"reference-count":38,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011576","name":"Inonu University Scientific Research Projects Coordination Unit","doi-asserted-by":"publisher","award":["TTU-2024-3736"],"award-info":[{"award-number":["TTU-2024-3736"]}],"id":[{"id":"10.13039\/501100011576","id-type":"DOI","asserted-by":"publisher"}]},{"award":["TTU-2024-3736"],"award-info":[{"award-number":["TTU-2024-3736"]}],"id":[{"id":"https:\/\/ror.org\/04asck240","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Cardiovasc. Dev. Dis.","JCDD"],"abstract":"<jats:p>Background: We evaluated the diagnostic discrimination of serum endothelin-1 (ET-1), copeptin, and chemerin in adults evaluated for acute pulmonary embolism (PE). Methods: This prospective, single-center diagnostic study included 65 adults with CTPA-confirmed PE and 64 CTPA-negative controls recruited from the same emergency-department source population of patients evaluated for suspected PE. Controls were consecutively enrolled among dyspneic patients in whom CTPA excluded PE; no individual matching was used. Biomarkers were compared with D-dimer and the Wells score. Results: ET-1 was higher in the PE group (median, 12.96 vs. 6.41 pg\/mL; p &lt; 0.001) and showed moderate discrimination (AUROC, 0.731; 95% CI, 0.644\u20130.818), but was inferior to D-dimer (AUROC, 0.905; 95% CI, 0.852\u20130.958). Adding ET-1 to D-dimer changed the AUROC from 0.905 to 0.923 (DeLong p = 0.128), and adding ET-1 to Wells plus D-dimer changed it from 0.966 to 0.971 (DeLong p = 0.224). An age-adjusted D-dimer threshold preserved sensitivity (96.9%) and increased specificity from 48.4% to 56.3% relative to 0.50 mg\/L FEU. Conclusions: ET-1 was associated with acute PE in this selected sample but did not materially improve discrimination beyond established comparators. Because the near-ceiling Wells\u2013D-dimer model and selected sampling frame limit inference, external validation in an unselected diagnostic cohort is required.<\/jats:p>","DOI":"10.3390\/jcdd13090448","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:05:43Z","timestamp":1788941143000},"page":"448","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Serum Endothelin-1 in Suspected Acute Pulmonary Embolism: A Prospective Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2996-4549","authenticated-orcid":false,"given":"Mahmut","family":"Murat","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Mersin City Training and Research Hospital, 33240 Mersin, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5505-6250","authenticated-orcid":false,"given":"Mustafa Safa","family":"Pepele","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inonu University School of Medicine, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"project-administration","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5618-8514","authenticated-orcid":false,"given":"Serdar","family":"Derya","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inonu University School of Medicine, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0377-0956","authenticated-orcid":false,"given":"G\u00f6kay","family":"S\u00fcl\u00fc","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yesilyurt Hasan Calik District State Hospital, 44915 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5845-2614","authenticated-orcid":false,"given":"Neslihan","family":"Y\u00fccel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inonu University School of Medicine, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Cuma","family":"Merto\u011flu","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Inonu University School of Medicine, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Hasan Cengizhan","family":"Kat\u0131rc\u0131","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Inonu University School of Medicine, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Ahmet Burak","family":"Avcu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Inonu University School of Medicine, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur. 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