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Regulation of sympathetic activity in children with various congenital heart diseases
1Biological and Medical Research Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
Children with congenital heart disease show altered adrenoceptor activity. Platelet alpha-adrenoceptor density increased, while lymphocyte beta-adrenoceptor density decreased, with elevated catecholamines in these patients.
Area of Science:
- Cardiology
- Pharmacology
- Pediatrics
Background:
- Congenital heart diseases (CHDs) in children can affect autonomic nervous system function.
- Adrenoceptors play a crucial role in cardiovascular regulation.
Purpose of the Study:
- To investigate alpha- and beta-adrenoceptor activity, catecholamine, and cAMP levels in pediatric patients with various CHDs.
- To compare these parameters between acyanotic and cyanotic CHD groups and a control group.
Main Methods:
- Studied 112 children with CHDs (e.g., tetralogy of Fallot, VSDs, pulmonary stenosis, coarctation of the aorta) and 14 controls undergoing PDA occlusion.
- Measured platelet alpha- and lymphocyte beta-adrenoceptor density and plasma catecholamine (norepinephrine, epinephrine, dopamine) and cAMP levels.
Main Results:
- Mean platelet alpha-adrenoceptor density was significantly elevated (73%) in CHD patients (both acyanotic and cyanotic) compared to controls.
- Mean lymphocyte beta-adrenoceptor density was significantly attenuated (27%) in CHD patients, particularly in left-to-right shunts and pulmonary stenosis groups.
- Plasma levels of norepinephrine, epinephrine, and dopamine were elevated in CHD patients, while cAMP levels remained unchanged.
Conclusions:
- Pediatric patients with CHDs exhibit significant alterations in adrenoceptor density and catecholamine levels.
- These findings suggest a dysregulation of the sympathetic nervous system in children with congenital heart conditions.
Abstract:
We studied the alpha- and beta-adrenoceptor activity and catecholamine and cAMP levels in 112 children and infants admitted to the hospital for diagnostic or interventional catheterization of tetralogy of Fallot, ventricular septal defects with or without hypertension, pulmonary stenosis, coarctation of the aorta, and various complex cyanotic congenital cardiac diseases and compared them with 14 children undergoing transcatheter occlusion of patent ductus arteriosus with insignificant left-to-right-shunts. The mean total platelet alpha-adrenoceptor density of the study population was elevated by 73%. Both the increases in acyanotic (p < 0.05) and cyanotic (p < 0.005) patients as well as the difference between the two groups (p < 0.01) were significant. Based on the congenital disease classification, the elevation in receptor density was also significant in all groups of patients, except coarctation of the aorta. On the other hand, the mean lymphocyte beta-adrenoceptor density was attenuated by 27%, showing significant difference between the acyanotic and the patent ductus arteriosus groups, but none between acyanotic and cyanotic or cyanotic and the patent ductus arteriosus groups. Among the congenital groups, only the left-to-right shunts and the pulmonary stenosis group showed significant (p < 0.05) decrease in beta-adrenoceptor density, whereas the affinity of all the groups toward [125I]iodocyanopindolol was hardly influenced. The plasma levels of all three catecholamines, norepinephrine, epinephrine, and dopamine, were elevated, but cAMP remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)