Relationship between hemodynamics and plasma atrial natriuretic peptide in children with ventricular septal defect or...

To evaluate the relationship between concentrations of ANP in plasma of the right-sided central circulation and hemodynamic parameters in congenital heart disease with left-to-right shunt. We enrolled 20 children aged from 1 month to 4.8 years with ventricular septal defect (VSD) or patent ductus arteriosus (PDA). The concentrations of ANP in plasma were extracted through a cartridge (Sep-Pak C18) before being measured by radioimmunoassay. Significant increased concentrations of ANP in plasma from inferior vena cava (117.6 +/- 18.1 pg/mL), right atrium (160.6 +/- 21.6 pg/mL) to pulmonary artery (PA) (253.4 +/- 38.8 pg/mL) were recognized. In VSD (n = 10) and PDA (n = 10), the concentrations of ANP in plasma from the inferior vena cava correlated significantly with the ratio of pulmonary to systemic blood flow (Qp/Qs) (r = 0.69, p < 0.05; r = 0.94, p < 0.01 respectively), the systolic pulmonary artery pressure (r = 0.90, p < 0.01; r = 0.93, p < 0.01 respectively), the diastolic pulmonary artery pressure (r = 0.76, p < 0.02; r = 0.68, p < 0.05 respectively), and the mean pulmonary artery pressure (r = 0.88, p < 0.01; r = 0.87, p < 0.01 respectively). The concentrations of ANP in plasma from the pulmonary artery also correlated significantly with the Qp/Qs (r = 0.81, p < 0.01; r = 0.87, p < 0.01 respectively). The results indicated that left atrial volume loading may have an important influence on secretion of ANP in some congenital heart disease with left to right shunt.