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Plasma atrial natriuretic peptide in patients with congenital heart diseases
S Matsuoka1, Y Kurahashi, Y Miki
1Department of Pediatrics, University Hospital of Tokushima, Japan.
Insights
Plasma levels of human alpha-atrial natriuretic peptide increase in children with specific congenital heart defects, indicating its role in volume regulation. These elevated levels correlate with left atrial enlargement.
Area of Science:
- Cardiology
- Pediatrics
- Endocrinology
Background:
- Congenital heart diseases (CHDs) affect cardiac structure and function.
- Atrial natriuretic peptide (ANP) plays a role in cardiovascular homeostasis.
- Understanding ANP levels in pediatric CHDs is crucial for assessing disease severity and management.
Purpose of the Study:
- To measure plasma levels of human alpha-atrial natriuretic peptide (alpha-ANP) in children with CHDs.
- To investigate the correlation between alpha-ANP levels and specific CHD types.
- To explore the relationship between alpha-ANP levels and atrial dimensions.
Main Methods:
- Plasma alpha-ANP levels were measured in healthy children and patients aged 1 month to 15 years with various CHDs.
- Statistical analysis was used to compare ANP levels between groups and correlate them with clinical parameters.
Main Results:
- Significant increases in alpha-ANP were observed in patients with ventricular septal defect (VSD), tricuspid valve atresia, patent ductus arteriosus (PDA), and atrial septal defect (ASD).
- ANP levels were highest in VSD and PDA compared to ASD.
- Elevated ANP levels correlated significantly with left atrial enlargement (r = .85, P < .01) but not right atrial size or pressure.
Conclusions:
- Human alpha-ANP is released into circulation in response to chronic atrial expansion in pediatric CHDs.
- Alpha-ANP may play a significant role in maintaining volume homeostasis in children with CHDs.
- The findings highlight the utility of alpha-ANP as a biomarker for assessing hemodynamic changes in pediatric congenital heart disease.
Abstract:
The plasma level of human alpha-atrial natriuretic peptide was measured in healthy children and patients, 1 month to 15 years of age, with congenital heart diseases. Significant increases were found in patients with a ventricular septal defect, tricuspid valve atresia, patent ductus arteriosus, and atrial septal defect but not in those with pulmonary valve stenosis or tetralogy of Fallot. The levels were significantly higher in children with ventricular septal defects (221 +/- 123 pg/mL) or patent ductus arteriosus (124 +/- 38 pg/mL) than in those with atrial septal defects (65 +/- 42 pg/mL) (P less than .01). The increased levels appeared to be correlated with enlargement of the left atrium (r = .85, P less than .01) but not with the right atrial size or the mean right atrial pressure. They were higher in younger than in older healthy infants, but this age difference did not affect the results. These findings indicate that human alpha-atrial natriuretic peptide is released into the circulation in response to chronic atrial expansion in patients with congenital heart disease and may have an important role in volume homeostasis.