ABSTRACT
Objective To study the value of plasma brain natriuretic peptide (BNP) levels on the cardiac function evaluation in children with left-right shunt congenital heart disease (CHD).Methods Thirtytwo children with left-right shunt CHD were selected and divided into right ventricular group (14 cases) and left ventricular group (18 cases) according to the heart load capacity types.Twenty healthy children were selected as control group.Then plasma BNP levels were determined by enzyme-linked immunosorbent assay method and the left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),right ventricular end-diastolic diameter (RVEDD),pulmonary blood flow (Qp)/systemic blood flow ratio(Qs) and left heart Tei index were determined by echocardiography and compared.Results The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (60.21 ± 26.78) rng/L,(35.71 ± 6.98) mm,(25.04 ± 5.52) mm,1.74 ± 0.24,0.34 ± 0.12 in right ventricular group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (64.57 ± 25.18) ng/L,(45.27 ± 7.26) mm,(12.34 ± 2.18) mm,1.78 ± 0.19,0.36 ± 0.11 in left ventricular group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (33.42 ± 9.46) ng/L,(32.31 ± 4.87) mm,(10.98 ± 1.60) mm,0.92 ± 0.11,0.28 ± 0.08 in control group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index in right ventricular group and left ventricular group were higher than those in control group,and there were significant differences (P ＜ 0.05).There was no significant difference in LVEF among three groups (P ＞ 0.05).The plasma BNP levels in right ventricular group had positive correlation with RVEDD (r =0.634,P ＜ 0.05),Qp/Qs (r =0.721,P ＜ 0.05) and left heart Tei index (r =0.647,P ＜ 0.05).The plasma BNP levels in left ventricular group had postive correlation with LVEDD (r =0.547,P ＜ 0.05),Qp/Qs(r =0.794,P ＜ 0.05) and left heart Tei index (r =0.745,P ＜ 0.05).There was no correlation between the plasma BNP levels and LVEF in right ventricular group and left ventricular group.Conclusion The plasma BNP levels determination helps the early cardiac function evaluation of left-right shunt CHD,and combined with echocardiography can accurately reflect the early cardiac function of the left-right shunt CHD,which can provide objective basis for the clinical diagnosis and treatment.
ABSTRACT
Objective To explore the relationship between dynamic changes in ultra-micro-structural of pulmonary arteries and endogenous hydrogen sulfide in rats with left-right shunt.Methods Rats in shunt group were subjected to an abdominal aorta-inferior vena cava shunt to create an animal model of pulmonary artery structural remodeling. After 1 day, 3 days, 1 week, 4 weeks and 8 weeks of experiment, the ultra-micro-morphologic changes of pulmonary arteries of rats were observed under electronic microscope and H_2S concentration in serum was evaluated by modified sulfide electrode method.Results The changes of ultra-micro-structure of pulmonary arteries were progressively exacerbated, endothelial cells became swollen and large in size on 3 days, smooth muscular cells increased in size as well as the change of endothelial cells in 1 week, and they changed from contractile phenotype to synthetic phenotype in 4 weeks.Conclusions Shunt exhibited changes of ultra-micro-structure of pulmonary arteries are accompanied by the changes of endogenous H_2S. It is suggested that endogenous H_2S might play a protective role in changes of ultra-micro-structure of pulmonary artery.
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AIM To explore the effect of long-term nebulized inhalation of nitroglycerin (Neb-NTG) on high pulmonary blood flow-induced pulmonary artery hypertension (PAH). METHODS 24 male Wistar rats were randomly divided into shunting group, Neb group and control group. An arteries-venous shunt was performed between the abdominal aorta and inferior vena cava shunting was produced in rats of Neb and shunt groups. Twelve weeks after the operation, nebulized nitroglycerin was inhaled by rats in the Neb group using pressurized air ejection mobilization, while nebulized saline was inhaled by rats of the other two groups. Ten minutes inhalation was given each day for each rat. After three weeks of inhalation, pulmonary artery systolic pressure (PASP) and mean pressure (PAMP) of each rat were evaluated by using a right cardiac catheterization procedure. Systemic arterial pressure (SAP) was reorded continuously by catheterization procedure. The ratio of right ventricular mass to body weight (RV/BW) and the ratio of right ventricular mass to left ventricular plus septal mass (RV/LV+S) were detected. Pulmonary vascular microstructure was measured. RESULTS PASP, RV/BW and RV/LV+S were significantly increased in shunt rats as compared with those of normal controls (P0.05). Muscularization of small pulmonary artery was obviously decreased in Neb-group compared with shunt group. CONCLUSION Long-term Neb-NTG ameliorates high pulmonary blood flow-induced PAH and pulmonary vascular remodeling.
ABSTRACT
OBJECTIVE:To study the preventive and therapeutic actions of L-arginine on pulmonary hypertension induced by high pulmonary blood flow volume.METHODS:Male SD rats were randomly divided into control group(n=6),shunt group (n=7) and shunt+L-arginine group(n=8).Abdominal aorta-inferior vena cava shunt was performed to make the blood flow from left to right,11 weeks later,mPAP was detected with right cardiac catheter;the structure of pulmonary vessels and expression of PCNA of smooth muscle cells were observed.RESULTS:The mPAP of shunt group was obviously higher than that of control(P