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Angiotensin converting enzyme activity in children with congenital heart disease
U Salzer-Muhar1, W Graninger, H R Salzer
1Department of Paediatrics, University of Vienna, Austria.
Insights
Serum angiotensin converting enzyme (ACE) activity showed no significant differences in children with congenital heart disease and varying lung perfusion. However, in cases of increased pulmonary blood flow, ACE activity tended to inversely correlate with pulmonary arterial pressure and resistance.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
- Biochemistry
Background:
- Congenital heart disease (CHD) encompasses structural abnormalities present at birth.
- Pulmonary perfusion can be normal, increased, or decreased in children with CHD.
- Serum angiotensin converting enzyme (ACE) plays a role in cardiovascular regulation.
Purpose of the Study:
- To investigate serum ACE activity in pediatric patients with CHD.
- To determine if serum ACE activity differs based on the degree of pulmonary blood flow.
- To explore correlations between serum ACE activity and hemodynamic parameters in CHD.
Main Methods:
- Serum ACE activity was measured in 46 children with CHD.
- Patients were categorized into three groups based on pulmonary blood flow: normal, increased, and decreased.
- Hemodynamic data, including mean pulmonary arterial pressure and pulmonary vascular resistance, were analyzed.
Main Results:
- No significant differences in serum ACE activity were observed across the three groups.
- In the group with increased pulmonary blood flow, serum ACE activity showed a trend towards inverse correlation with mean pulmonary arterial pressure (r = -0.43, P ≤ 0.05).
- A similar inverse correlation trend was noted between serum ACE activity and pulmonary vascular resistance (r = -0.48, P = 0.05) in this group.
Conclusions:
- Serum ACE activity does not significantly vary with different levels of pulmonary perfusion in children with CHD.
- A potential inverse relationship between serum ACE activity and pulmonary hypertension markers exists in CHD with increased pulmonary blood flow.
- Further research is needed to elucidate the role of ACE in the pathophysiology of pulmonary hypertension secondary to CHD.
Abstract:
Serum angiotensin converting enzyme (ACE) activity was determined in 46 children with congenital heart disease with normal and abnormal lung perfusion: (1) congenital heart disease with normal pulmonary blood flow (12 patients); (2) congenital heart disease with increased pulmonary blood flow (18 patients); (3) congenital heart disease with decreased pulmonary blood flow (16 patients). There was no significant difference in serum ACE activity between the three groups. In group 2 serum ACE activity had a tendency to correlate inversely with both mean pulmonary arterial pressure (r = -0.43; P less than or equal to 0.05) and pulmonary vascular resistance (r = -0.48; P = 0.05). No further correlations between serum ACE activity and age, serum electrolytes, creatinine nor other haemodynamic data could be established.