© 2000 European Society of Cardiology
Serum N-terminal atrial natriuretic peptide in adult patients late after surgical repair of atrial septal defect
a Department of Clinical Physiology, Tampere University Hospital P.O. Box 2000, FIN-33520 Tampere, Finland
b Department of Internal Medicine, Tampere University Hospital Tampere, Finland
* Corresponding author. Tel.: +358-3-2475111; fax: +358-3-2475511. E-mail address: kljola{at}uta.fi (T.E. Iivainen).
 |
Abstract |
|---|
Background: The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases.
Aims: To examine whether patients after surgical repair of ASD have higher concentrations of N-terminal atrial natriuretic peptide (ANP-N) than age-, sex- and body mass index (BMI)-matched control subjects.
Methods: Medical history, physical examination, standard 12-lead electrocardiogram, and ANP-N concentrations were obtained in 65 adult patients operated for ASD at the age of 21 ± 13 years (mean ± standard deviation), 21 ± 6 years after surgical closure of ASD. Sixty-seven healthy subjects matched for age, sex and BMI served as controls.
Results: In the patients serum ANP-N was higher than in the control subjects 0.41 ± 0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21–0.49 nmol/l vs. 0.24 ± 0.12 nmol/l, median 0.23 nmol/l, IQR 0.17–0.29 nmol/l, (P = 0.0003). Patients with concomitant diseases had higher ANP-N concentrations (0.51 ± 0.39 nmol/l, median 0.34, IQR 0.26–0.73 nmol/l) than ASD patients without any history or signs of disease (0.28 ± 0.16 nmol/l, median 0.27, IQR 0.17–0.40 nmol/l, P = 0.01). The ‘healthy’ ASD patients had higher hormone concentrations than age-, sex- and BMI-matched control subjects (0.28 ± 0.16 median 0.27 nmol/l, IQR 0.17–0.40 nmol/l and 0.21 ± 0.07 nmol/l, median 0.20 nmol/l, IQR 0.15–0.27 nmol/l, P = 0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post-operative ANP-N concentration (r2 = 0.25, P = 0.0002).
Conclusion: ASD patients have higher ANP-N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence.
Key Words: Atrial septal defect • Heart • Surgery • Congenital heart defect • Haemodynamics • Natriuretic peptide
Received February 12, 1999; Revised February 23, 2000; Accepted March 6, 2000
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K. Dimopoulos, D. O. Okonko, G.-P. Diller, C. S. Broberg, T. V. Salukhe, S. V. Babu-Narayan, W. Li, A. Uebing, S. Bayne, R. Wensel, et al. Abnormal Ventilatory Response to Exercise in Adults With Congenital Heart Disease Relates to Cyanosis and Predicts Survival Circulation, June 20, 2006; 113(24): 2796 - 2802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P Bolger, A. J.S Coats, and M. A Gatzoulis Congenital heart disease: the original heart failure syndrome Eur. Heart J., May 2, 2003; 24(10): 970 - 976. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Bolger, R. Sharma, W. Li, M. Leenarts, P. R. Kalra, M. Kemp, A. J.S. Coats, S. D. Anker, and M. A. Gatzoulis Neurohormonal Activation and the Chronic Heart Failure Syndrome in Adults With Congenital Heart Disease Circulation, July 2, 2002; 106(1): 92 - 99. [Abstract] [Full Text] [PDF]
|
|