Molecular Biologic Approach of Coronary Circulation and Coronary Endothelial Function in Patients with Cyanotic Heart Disease

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Background: Previous study demonstrated that endothelial function could be damaged by the acute hypoxia in the setting of the animal experimental model. Endothelial-derived nitric oxide and endothelial prostaglandins are released in response to the increase in shear stress due to hyperviscosity of erythrocytosis. In this regard, we hypothesized that vascular endothelial function may be damaged by long-standing cyanosis or hemodynamic stress in adult patients with cyanotic heart disease. However, little is known about endothelial function in adult patients with cyanotic heart disease. Objective: The purpose of this study was to evaluate the endothelial function and its related factors in adult patients with cyanotic heart disease. Methods: Forearm blood flow (FBF) response to handgrip exercise or brachial arterial occlusion were assessed in 14 patients with cyanotic heart disease (mean age: 26.8±6.0 years, SaO2: 82.1±8.4%) and age-matched control (mean age: 30.9±8.3 years, Sa02: 98.1±0. … More 9%) using strain gauge plethysmography. As the related factors of vascular endothelial function, red blood cell (RBC), uric acid, MDA-LDL, ICAM-1, von Willebrand factor, thrombomodulin, endothelin, erythropoietin, urine 8-hydroxy-2'-deoxyguanosine and urine NOx level were analyzed. Results: Percent change of FBF to handgrip exercise in cyanotic patients was significantly deteriorated than that in control (882.6±358.8% vs. 1428.41447.6%, p=0.007). Similarly, percent change of FBF to brachial arterial occlusion in cyanotic patients was significantly deteriorated than that in control (292.6±89.9% vs. 455.6±117.8%, p=0.002). Such percent changes were significantly correlated with oxygen saturation, RBC and ICAM-1 level. Conclusions: From these results, we concluded that vascular endothelial impairment exists in adult patients with cyanotic heart disease and closely related with severity of cyanosis or vascular. Shear stress. Such impaired endothelial function may influence on the long-term outcome in these populations. Less