Expression of connective tissue growth factor in the serum of children with congenital heart disease combined with pulmonary hypertension / 中华实用儿科临床杂志

ABSTRACT

Objective To further study the pathogenesis for congenital heart disease (CHD) and connective tissue growth factor(CTGF) for the early diagnosis of CHD and pulmonary hypertension (PH).Methods Sixty-six cases of children with CHD were selected from the thoracic surgery who were performed in the Children's Hospital of Shanxi Province during the period between Sep.2012 and Jan.2013.Based on the cardiac color Doppler estimation of the pulmonary artery systolic pressure,they were classified into several groupsunincorporated PH group with 16 cases,mild PH group with 18 cases,moderate PH group with 17 cases,and severe PH group with 15 cases.Based on types,the 66 cases could be classified as ventricular septal defect (VSD) group with 23 cases,atrial septal defect (ASD) group with 17 cases,patent ductus arteriosus(PDA) group with 14 cases,and composite(including 2 or more of the congenital cardiovascular anomalies) group with 12 cases.Twenty healthy children who had medical examination over the same period in the Children's Hospital of Shanxi Province were randomly chosen as the healthy control group.The serum concentration of CTGF in the research objects were determined with the aid of double antibody sandwich enzyme-linked immunosorbent assay method.According to the different pulmonary artery systolic pressure and different types of CHD,the serum concentration of CTGF were compared among groups.The correlation of between the CTGF concentration in the serum and pulmonary artery systolic pressure were also analyzed among the groups of children with CHD.Results Quantitative measurement revealed that the serum CTGF concentration measured in the groups of children with CHD were significantly higher than that in the healthy control group(P ＜ 0.05) ; the serum CTGF concentration of the children with CHD and PH was higher than that in the group of children with CHD alone(P ＜ 0.05).With the increase in pulmonary artery pressure,CHD patients serum levels of CTGF also increased(P ＜ 0.05).By the correlation analysis,the results showed that the serum level of CTGF in the CHD groups were positively correlated with the pulmonary artery pressure (r =0.670,P =0.005 ; r =0.514.P =0.029 ; r =0.517,P =0.034 ; r =0.707,P =0.003).The difference in terms of serum CTGF concentration in different types of CHD patients was not significant (F =0.270,P =0.847).Conclusions There exists certain damage in CHD early myocardial fibrosis(unincorporated PH),when combined with PH,myocardial fibrosis increases with the gradual increase of pulmonary artery pressure.However,the degree of myocardial fibrosis shows no correlation with the type of CHD.