Natriuretic peptide and echocardiography after operation of atrial septal defect.

Autor: Groundstroem KW; Department of Internal Medicine, Tampere University Hospital, FIN-33250 Tampere, Finland. kaj.groundstroem@uta.fi, Iivainen TE, Lahtela JT, Talvensaari TJ, Paakkala TA, Pasternack AI, Uusitalo AJ
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2003 May; Vol. 89 (1), pp. 45-52.
DOI: 10.1016/s0167-5273(02)00427-8
Abstrakt: Patients benefit from surgical seclusion of atrial septal defect but have excessive cardiovascular morbidity after the operation. We evaluated haemodynamics and looked for abnormalities of cardiac structures and function late after surgical seclusion of the defect. Serum N-terminal natriuretic peptide measurement and transthoracic and transoesophageal echocardiography were performed in 61 patients aged 43+/-15 years (mean+/-standard deviation) 21+/-5 years after surgery. The findings were compared with 67 control subjects. The patients had higher serum N-terminal atrial natriuretic peptide concentration than the control subjects (0.40+/-0.32 vs. 0.24+/-0.12 nmol/l, P=0.0001). Peptide levels correlated with current age (P=0.0001) and age at operation (P=0.0014), but not with age in the control subjects. In the patients, echocardiography measurements of cardiac dimensions correlated with hormone levels (atrial natriuretic peptide concentration with left atrial end-systolic diameter (P=0.042), left ventricular end-diastolic (P=0.021) and end-systolic diameter (P=0.042). There were only 10 patients (16%) without any abnormality in echocardiography. Their peptide concentration was 0.25+/-0.18 nmol/l (P=not significant compared to the control subjects). The association between increasing N-terminal atrial peptide levels and operation age together with echocardiography findings support the clinical consensus of treating atrial septal defect patients in their childhood and adolescence.
Databáze: MEDLINE