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Related Experiment Videos

Neurohormonal activation late after cavopulmonary connection.

V E Hjortdal1, E V Stenbøg, H B Ravn

  • 1Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby Section, DK-8200 Aarhus N, Denmark. vibeke.hjortdal@dadlnet.dk

Heart (British Cardiac Society)
|March 18, 2000
PubMed
Summary

Patients with cavopulmonary connection show elevated neurohormone levels, including angiotensin II and aldosterone, years after surgery. Hormone levels decrease over time, suggesting physiological adaptation post-operation.

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Endocrinology

Background:

  • Patients with cavopulmonary connection often exhibit altered fluid and electrolyte balance.
  • Vasoactive and water-salt regulating hormones play a crucial role in cardiovascular homeostasis.

Purpose of the Study:

  • To investigate elevated levels of vasoactive/water-salt regulating hormones in patients post-cavopulmonary connection.
  • To determine the relationship between these hormone levels and postoperative hemodynamics and long-term follow-up.

Main Methods:

  • A cross-sectional study involving 20 patients (aged 4-22) who underwent total cavopulmonary connection (TCPC) or bidirectional Glenn anastomosis (BDG).
  • Cardiac catheterization and blood sampling were performed to measure plasma levels of angiotensin II, renin, aldosterone, vasopressin, atrial natriuretic factor (ANF), and brain natriuretic peptide (BNP).

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  • Comparison with 33 healthy children.

    • Main Results:

    • Significantly increased plasma levels of all measured neurohormones were observed in both TCPC and BDG patients compared to controls.
    • A fourfold increase in angiotensin II, renin, and aldosterone, and a twofold increase in vasopressin, ANF, and BNP were noted.
    • No correlation was found between hemodynamic variables and hormone levels, but angiotensin II and renin inversely correlated with time to follow-up. Neurohormonal levels normalized in subjects over 15 years old.

    Conclusions:

    • Neurohormone levels remain elevated for years after successful cavopulmonary operations.
    • Decreasing hormone levels over time suggest physiological adaptation.
    • Neurohormonal activation is primarily linked to altered postoperative physiology, with adaptation occurring gradually.