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

Yıl 2018, Cilt: 32 Sayı: 2, 123 - 130, 27.08.2018
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.

Kaynakça

  • Hsu DT, Pearson GD. Heart failure in children: part I: history, etiology, and pathophysiology. Circulation 2009;2(1):63-70.
  • Kuwahara K, Saito Y, Harada M ve ark. Involvement of cardiotrophin-1 in cardiac myocyte-nonmyocyte interactions during hypertrophy of rat cardiac myocytes in vitro. Circulation. 1999;100(10):1116-24.
  • Freed DH, Moon MC, Borowiec AM ve ark. Cardiotrophin-1: expression in experimental myocardial infarction and potential role in post-MI wound healing. Mol Cell Biochem. 2003;254:247-56.
  • Freed DH, Borowiec AM, Angelovska T ve ark. Induction of protein synthesis in cardiac fibroblasts by cardiotrophin-1: integration of multiple signaling pathways. Cardiovasc Res. 2003;60:365-75.
  • Latchman DS. Cardiotrophin-1 (CT-1): a novel hypertrophic and cardioprotective agent. Int J Exp Pathol. 1999;80:189-196.
  • Jougasaki M, Tachibana I, Luchner A ve ark. Augmented cardiac cardiotrophin-1 in experimental congestive heart failure. Circulation. 2000;101:14-7.
  • Berezin AE.Prognostication in different heart failure phenotypes: The Role of Circulating Biomarkers. J Circ Biomark. 2016; 16:6.
  • Pennica D, King KL, Shaw KJ ve ark. Expression cloning of cardiotrophin 1, a cytokine that induces cardiac myocyte hypertrophy. Proc Natl Acad Sci USA. 1995;92:1142-46.
  • Stephanou A, Brar B, Heads R ve ark. Cardiotrophin-1 Induces Heat Shock Protein Accumulation in Cultured Cardiac Cells and Protects them from Stressful Stimuli. J Mol Cell Cardiol. 1998;30:849-55.
  • Wollert K, Taga T, Saito M ve ark. Cardiotrophin-1 activates a distinct form of cardiac muscle cell hypertrophy. Assembly of sarcomeric units in series VIA gp130/leukemia inhibitory factor receptor-dependent pathways. J Biol Chem. 1996;271:9535-45.
  • Talwar S, Downie P, Squire I ve ark. An immunoluminometric assay for cardiotrophin-1: a newly identified cytokine is present in normal human plasma and is increased in heart failure. Biochem Biophys Res Commun. 1999;261:567-71
  • Lorenzo-Almorós A, Tuñón J, Orejas M, Cortés M, Egido J, Lorenzo Ó. Diagnostic approaches for diabetic cardiomyopathy. Cardiovasc Diabetol. 2017;16:28.
  • Tsutamoto T, Asai S, Tanaka T ve ark. Plasma level of cardiotrophin-1 as a prognostic predictor in patients with chronic heart failure. Eur J Heart Fail. 2007;9:1032-7.
  • Cantinotti M, Giovannini S, Murzi B ve ark. Diagnostic, prognostic and therapeutic relevance of B-type natriuretic hormone and related peptides in children with congenital heart diseases. Clin Chem Lab Med. 2011;49:567-80.
  • Jougasaki M. Cardiotrophin-1 in cardiovascular regulation. Adv Clin Chem. 2010;52:41-76.
  • Kunii Y, Kamada M, Ohtsuki S, Araki T, Kataoka K, Kageyama M, Nakagawa N, Seino Y. Plasma brain natriuretic peptide and the evaluation of volume overloadm in infants and children with congenital heart disease. Acta Med Okayama. 2003;57:191-7.
  • Gonzalez A, Lopez B, Martín-Raymondi D ve ark. Usefulness of plasma cardiotrophin-1 in assessment of left ventricular hypertrophy regression in hypertensive patients. J Hypertens. 2005;23:2297-304.
  • Lopez B, Gonzalez A, Lasarte JJ ve ark. Is plasma cardiotrophin-1 a marker of hypertensive heart disease? J Hypertens. 2005;23:625-32.
  • Monserrat L, Lopez B, Gonzalez A ve ark. Cardiotrophin-1 plasma levels are associated with the severity of hypertrophy in hypertrophic cardiomyopathy. Eur Heart J. 2011;32:177-83.
  • Talwar S, Squire IB, Downie PF ve ark. Elevated circulating cardiotrophin-1 in heart failure: relationship with parameters of left ventricular systolic dysfunction. Clin Sci. 2000;99:83-8.
  • Tsutamoto T, Wada A, Maeda K ve ark. Relationship between plasma level of cardiotrophin-1 and left ventricular mass index in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2001;38:1485-90.
  • Tsutamoto T, Asai S, Tanaka T ve ark. Plasma level of cardiotrophin-1 as a prognostic predictor in patients with chronic heart failure. Eur J Heart Fail. 2007;9:1032-7.

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

Yıl 2018, Cilt: 32 Sayı: 2, 123 - 130, 27.08.2018
https://doi.org/10.5505/deutfd.2018.30074

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.

Kaynakça

  • Hsu DT, Pearson GD. Heart failure in children: part I: history, etiology, and pathophysiology. Circulation 2009;2(1):63-70.
  • Kuwahara K, Saito Y, Harada M ve ark. Involvement of cardiotrophin-1 in cardiac myocyte-nonmyocyte interactions during hypertrophy of rat cardiac myocytes in vitro. Circulation. 1999;100(10):1116-24.
  • Freed DH, Moon MC, Borowiec AM ve ark. Cardiotrophin-1: expression in experimental myocardial infarction and potential role in post-MI wound healing. Mol Cell Biochem. 2003;254:247-56.
  • Freed DH, Borowiec AM, Angelovska T ve ark. Induction of protein synthesis in cardiac fibroblasts by cardiotrophin-1: integration of multiple signaling pathways. Cardiovasc Res. 2003;60:365-75.
  • Latchman DS. Cardiotrophin-1 (CT-1): a novel hypertrophic and cardioprotective agent. Int J Exp Pathol. 1999;80:189-196.
  • Jougasaki M, Tachibana I, Luchner A ve ark. Augmented cardiac cardiotrophin-1 in experimental congestive heart failure. Circulation. 2000;101:14-7.
  • Berezin AE.Prognostication in different heart failure phenotypes: The Role of Circulating Biomarkers. J Circ Biomark. 2016; 16:6.
  • Pennica D, King KL, Shaw KJ ve ark. Expression cloning of cardiotrophin 1, a cytokine that induces cardiac myocyte hypertrophy. Proc Natl Acad Sci USA. 1995;92:1142-46.
  • Stephanou A, Brar B, Heads R ve ark. Cardiotrophin-1 Induces Heat Shock Protein Accumulation in Cultured Cardiac Cells and Protects them from Stressful Stimuli. J Mol Cell Cardiol. 1998;30:849-55.
  • Wollert K, Taga T, Saito M ve ark. Cardiotrophin-1 activates a distinct form of cardiac muscle cell hypertrophy. Assembly of sarcomeric units in series VIA gp130/leukemia inhibitory factor receptor-dependent pathways. J Biol Chem. 1996;271:9535-45.
  • Talwar S, Downie P, Squire I ve ark. An immunoluminometric assay for cardiotrophin-1: a newly identified cytokine is present in normal human plasma and is increased in heart failure. Biochem Biophys Res Commun. 1999;261:567-71
  • Lorenzo-Almorós A, Tuñón J, Orejas M, Cortés M, Egido J, Lorenzo Ó. Diagnostic approaches for diabetic cardiomyopathy. Cardiovasc Diabetol. 2017;16:28.
  • Tsutamoto T, Asai S, Tanaka T ve ark. Plasma level of cardiotrophin-1 as a prognostic predictor in patients with chronic heart failure. Eur J Heart Fail. 2007;9:1032-7.
  • Cantinotti M, Giovannini S, Murzi B ve ark. Diagnostic, prognostic and therapeutic relevance of B-type natriuretic hormone and related peptides in children with congenital heart diseases. Clin Chem Lab Med. 2011;49:567-80.
  • Jougasaki M. Cardiotrophin-1 in cardiovascular regulation. Adv Clin Chem. 2010;52:41-76.
  • Kunii Y, Kamada M, Ohtsuki S, Araki T, Kataoka K, Kageyama M, Nakagawa N, Seino Y. Plasma brain natriuretic peptide and the evaluation of volume overloadm in infants and children with congenital heart disease. Acta Med Okayama. 2003;57:191-7.
  • Gonzalez A, Lopez B, Martín-Raymondi D ve ark. Usefulness of plasma cardiotrophin-1 in assessment of left ventricular hypertrophy regression in hypertensive patients. J Hypertens. 2005;23:2297-304.
  • Lopez B, Gonzalez A, Lasarte JJ ve ark. Is plasma cardiotrophin-1 a marker of hypertensive heart disease? J Hypertens. 2005;23:625-32.
  • Monserrat L, Lopez B, Gonzalez A ve ark. Cardiotrophin-1 plasma levels are associated with the severity of hypertrophy in hypertrophic cardiomyopathy. Eur Heart J. 2011;32:177-83.
  • Talwar S, Squire IB, Downie PF ve ark. Elevated circulating cardiotrophin-1 in heart failure: relationship with parameters of left ventricular systolic dysfunction. Clin Sci. 2000;99:83-8.
  • Tsutamoto T, Wada A, Maeda K ve ark. Relationship between plasma level of cardiotrophin-1 and left ventricular mass index in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2001;38:1485-90.
  • Tsutamoto T, Asai S, Tanaka T ve ark. Plasma level of cardiotrophin-1 as a prognostic predictor in patients with chronic heart failure. Eur J Heart Fail. 2007;9:1032-7.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Benhur Şirvan Çetin Bu kişi benim

Mustafa Kır 0000-0003-2542-876X

Nurettin Ünal Bu kişi benim

Tuncay Küme 0000-0003-3440-3513

Nuh Yılmaz Bu kişi benim

Yayımlanma Tarihi 27 Ağustos 2018
Gönderilme Tarihi 25 Şubat 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 32 Sayı: 2

Kaynak Göster

Vancouver Çetin BŞ, Kır M, Ünal N, Küme T, Yılmaz N. Soldan sağa şantlı doğumsal kalp hastalıklı çocuklarda şant miktarı ile ’’kardiyotrofin-1’’ ilişkisi. DEU Tıp Derg. 2018;32(2):123-30.