THE RELATIONSHIP BETWEEN LEFT TO RIGHT SHUNTING CONGENITAL HEART DISEASE AND CARDIOTROPHIN-1 IN CHILDREN

Yıl 2018, , 123 - 130, 27.08.2018

Benhur Şirvan Çetin Mustafa Kır , Nurettin Ünal Tuncay Küme , Nuh Yılmaz

https://doi.org/10.5505/deutfd.2018.30074

Öz

Objective: In our study, it was aimed to investigate the
interaction of serum cardiotrophin-1 (CT-1) levels in left to right shunting
congenital heart disease in children and to evaluate the change of this
biomarker with intracardiac defect features.Material
and Method:
We investigated 45 patients and 23 healthy children between 1 months and 13
years of age in our study. In the patient group, we identified an atrial septal
defect (ASD) in 19 cases, a ventricular septal defect (VSD) in 17 cases, an ASD
and VSD (ASD+VSD) in 6 cases and a patent ductus arteriosus (PDA) in 3 cases.
All children underwent a classical echocardiography (two-dimensional, M-Mode,
two-dimensional Doppler and colour Doppler echocardiography). In all patients,
plasma BNP levels were measured by chemiluminescence and CT-1 levels were
estimated by enzyme-linked immunosorbent assay (ELISA) method, synchronously
with echocardiographic studies.

Results: A positive
correlation was detected between CT-1 and the number of shunts (p<0.02, r=0.35)
in patient group and between CT-1 and the defect diameter (p<0.05, r=0.49)
in ASD group. Furthermore, the level of CT-1 was higher in cases with a wide
VSD than in control group (p<0,05). There was a negative correlation between
CT-1 and EF and SF in the group with a higher number of shunts (pulmonary blood
flow / systemic blood flow: Qp / Qs> 2) (p<0.001, r=0.71).

Conclusion: CT-1 has
been found to increase in the group with left to right shunting heart disease.
Furthermore, it was indicated that the increase in CT-1 was related to the
number of shunts in the group having more intracardiac shunts and a higher risk
of failure.

Anahtar Kelimeler

Congenital heart diseases, cardiotrophin-1, brain natriuretic peptide

Soldan sağa şantlı doğumsal kalp hastalıklı çocuklarda şant miktarı ile ''kardiyotrofin-1'' ilişkisi

Öz

Amaç: Çalışmamızda çocuklarda soldan sağa
şantlı doğumsal kalp hastalıklarında serum kardiyotrofin-1 (CT-1) düzeyleri ile
şant miktarının karşılıklı etkileşimlerini araştırmak, bu belirtecin
intrakardiyak defekt tipine göre değişimlerini incelemek amaçlanmıştır.

Gereç ve Yöntem: Çalışmamızda, 1 ay–13
yaşları arasında, 45 hasta ve 23 sağlıklı çocuk incelendi. Hasta grubu içinde
19 olguda atriyal septal defekt (ASD), 17 olguda ventriküler septal defekt
(VSD), 6 olguda ASD ve VSD (ASD+VSD) ve 3 olguda patent duktus arteriyozus
(PDA) mevcuttu. Tüm çocuklara konvansiyonel ekokardiyografi incelemesi (iki
boyutlu, M-Mode, iki boyutlu Doppler ve renkli Doppler ekokardiyografileri)
yapıldı. Tüm olgulardan ekokardiyografi çalışmaları ile eş zamanlı olarak
plazma BNP düzeyleri kemilüminisans ve CT-1 düzeyleri de “enzyme-linked
immunosorbent assay” (ELISA) yöntemleriyle ölçüldü.

Bulgular: Hasta grubunda CT-1
ile şant miktarı arasında (p<0,02, r=0,35), ASD grubunda da CT-1 ile defekt
çapı arasında pozitif korelasyon saptandı (p<0,05, r=0,49). Ayrıca, geniş
VSD’li olgularda CT-1 düzeyi kontrole göre yüksekti (p<0,05). Soldan-sağa
şant miktarı yüksek olan grupta (pulmoner kan akımı/sistemik kan akımı: Qp/Qs
>2) CT-1 ile EF ve FS arasında negatif korelasyon bulundu (p<0,001, r=0,71).

Sonuç: CT-1’in soldan sağa şantlı kalp
hastalıkları grubunda yükselmiş olduğu bulundu. Bunun yanı sıra intrakardiyak
şantı fazla, kalp yetersizliği riski yüksek olan grupta da CT-1’in şant
miktarıyla korele olarak arttığı saptandı. Sonuç olarak CT-1, erişkinlerde
olduğu gibi çocuklardaki kalp yetmezliğinin değerlendirilmesinde de
kullanılmaya aday bir belirteçtir. Ancak, çocukluk çağında CT-1 ile kalp
fonksiyonları arasındaki ilişkiyi ortaya koymak için daha fazla sayıda hastanın
incelendiği prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Doğumsal kalp hastalıkları, kardiyotrofin-1, beyin natriuretik peptit

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