Vasoactive mediators in congenital heart diseases with shunt lesions and pulmonary hypertension

Authors: FATMA SEDEF TUNAOĞLU, AYŞE ZENGİN TURAN, FATMA RANA OLGUNTÜRK, SERDAR KULA, AYŞE DENİZ OĞUZ

Abstract: Increased pulmonary flow in left-to-right shunt lesions and decreased pulmonary flow and hypoxia in right-to-left shunt lesions constitute the main cause of morbidity and mortality in congenital heart diseases. This study was planned to determine the relation of vasoactive mediators and pulmonary hypertension in congenital heart disease with shunt lesions. Materials and methods: Patients (31 females, 22 males; 5 months to 16 years old) were divided into 2 groups according to their shunt lesions (acyanotic, cyanotic), pulmonary artery mean pressure (below 30 mmHg: nonhypertensive, above 30 mmHg: hypertensive), and pulmonary resistance (below 2 U/m2: low, above 2 U/m2: high). The acyanotic group was further divided into subgroups based on pulmonary artery mean pressure values. Vascular endothelial growth factor, interleukin 6, interleukin 8, fibroblast growth factor, and endothelin levels were determined in systemic arterial, pulmonary artery, and venous blood samples. Results: All vascular endothelial growth factor levels were significantly elevated in the high pulmonary resistance group. Arterial and venous endothelin levels were significantly elevated in the cyanotic group and high pulmonary resistance group. Positive correlations were found between vascular endothelial growth factor and interleukin 6, interleukin 8, and pulmonary artery systolic pressures. Conclusion: Vascular endothelial growth factors play an important role in the development of irreversible pulmonary hypertension; therefore, evaluation of vascular endothelial growth factor levels could guide the management of treatment.

Keywords: Vascular endothelial growth factor, interleukin 6, interleukin 8, fibroblast growth factor, endothelin, congenital heart disease

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