Neurohormonal activation and the chronic heart failure syndrome in adults with congenital heart disease
Neurohormonal activation and the chronic heart failure syndrome in adults with congenital heart disease
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DOI：
10.1161/01.cir.0000020009.30736.3f
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发表时间：
2002-07-02
期刊：
影响因子：
37.8
通讯作者：
Gatzoulis, MA
中科院分区：
文献类型：
--
作者：
Bolger, AP;Sharma, R;Gatzoulis, MA
背景-神经激素激活是慢性心力衰竭的特征，与结果相关，并且是治疗目标。目前尚不清楚患有先天性心脏病的成人是否存在类似的神经激素激活模式，如果存在，它是否与疾病严重程度的常见衡量标准有关，或者心脏解剖结构是否是更好的判别因素。方法和结果-心房钠尿肽（ANP）、脑钠尿肽（BNP）、内皮素-1（ET-1）、肾素、 在 53 名患有先天性心脏病的成年人中测定了醛固酮、去甲肾上腺素和肾上腺素，包括 4 个不同的解剖亚组（29 名女性：33.5+/-1.5 岁：纽约心脏协会等级 2.0+/-0.1，平均值+/-SEM）和 15 名健康对照受试者（8 名女性 32,3 13 岁），全身心室功能通过盲法分级 超声心动图检查结果正常或轻度、中度或严重受损。患有先天性心脏病的成年人的 ANP 水平升高（56.6 pmol/L vs 3.1 pmol/L）。 BNP（35.8 与 5.7 pmol/L）、ET-1（2.5 与 0.7 pmol/L，所有 P
Background-Neurohormonal activation characterizes chronic heart failure, relates to outcome, and is a therapeutic target. It is not known whether a similar pattern of neurohormonal activation exists in adults with congenital heart disease and, if so, whether it relates to common measures of disease severity or whether cardiac anatomy is a better discriminant.Methods and Results-Concentrations of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1), renin, aldosterone, norepinephrine, and epinephrine were determined in 53 adults with congenital heart disease, comprising 4 distinct anatomic subgroups (29 female: 33.5+/-1.5 years of age: New York Heart Association class 2.0+/-0.1, mean+/-SEM) aid 15 healthy control subjects (8 female 32,3 13 years of age), Systemic ventricular function was graded by a blinded echocardiographer as normal or mildly, moderately, or severely impared. Adults with congenital heart disease had elevated levels of ANP (56.6 versus 3.1 pmol/L). BNP (35.8 versus 5.7 pmol/L), ET-1 (2.5 versus 0.7 pmol/L, all P