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KMID : 0367419940370040481
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Journal of Korean Pediatric Society
1994 Volume.37 No. 4 p.481 ~ p.493
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Plasma Atrial Natriuretic Peptide Concentrations of the Pulmonary artery, Aorta and Veins in Children with Caridac Disease
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이강일
허남근/현명철/이상범/양은경/이원정
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Abstract
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To study the site of release and factors affecting the release of the atrial natriuretic peptide(ANP) in the pediatric patients, we measured the plasma ANP concentrations in 23 normal healthy children, 19 patients with congestive heat failure and
16
patients with cardiac disease undergoing diagnostic cardiac catheterization.
@ES The following results were obtained.
@EN 1) The plasma ANP concentrations of the vein(226.3(74.9pg/ml)in patients with congestive heart failure were significantly higher than those(p<0.01)of the mormal healthy children(13.4 (7.9pg/ml)and those(43.3 40(.7pg/ml)in patients undergoing
cardiac
catheterization.
The plasma ANP concentrations of the femoral vein in patients undergoing cardiac catheterization were also significantly higher than that of the peripheral vein in the normal healthy children(p <0.01).
2) The plasma ANP concentrations of the pulmonary artery(110.9( 80.7pg/ml)were 2 to 3 times higher than that of the femoral vein(43.3( 40.3pg/ml, p<0.01). However there were no significant differences of the plasma ANP concentrations between
pulmonary
artery and aorta(65.4 (36.1pg/ml),and between aorta and femoral vein.
3) There was a significant correlations of the plasma ANP concentrations vetween pulmonary artery and femoral vein, and pulmonary artery and aorta, but no correlation of those between femoral vein and aorta.
4) The plasma ANP concentrations of the vein were over 3 times more higher in cases of left atrial area over 20 cm2/M2 measured by 2-dimensional echocardiography(213.2 (292.9pg/ml)than those in cases of left atrial area under 20(65.0 66.9pg/ml,
p
<0.05).
The plasma ANP concentrations of the vein were over 3 times more highger in cases of left atrial area over 20 cm2/M2(88.6(19.1pg/ml) than those in cases of left atrial area under 14(57.1 (39.5pg/ml,p <0.05), and in cases of the sum of both atrial
mean
pressure over 11mmHg(189.5( 42.8pg/ml) than those in cases of the sum under 11(79.3 (52.3pg/ml, p< 0.01).
The plasma ANP cocentrations of the aorta were significantly higher in cases of left atrial area over 14 cm2/M2(88.6 (19.1pg/ml)than those in cases of left atrial area under 14(57.1 (39.5pg/ml;p 0.05), in cases of the sum of both atrial area over
25cm2/M2(93.9 (21.7pg/ml)those in cases of the sum under 25(46.6 (33.8pg/ml,p< 0.01), in cases of sum of mean atrial pressure over 11 mmHg(90.5 (30.3pg/ml)than those in cases of under 11(53.8( 24.6pg/ml, p <0.05),in cases of the sum of both
atrial
wall
stress over 190 mmHg.cm2/M2(101.4 (23.5pg/ml) than those in cases of the sumunder 190(57.5 (26.4pg/ml, p <0.01), and also in cases of pulmonary artery mean pressure over 20mmHg(83.3( 18.2pg/ml) than those in cases o pulmonary artery under
20(47.8(
39.8pg/ml, p <0.05).
In conclusion, the plasma ANP concentrations of the pulmonary artery were significantly higher than those of the frmoral vein and the aorta, which indicater that the ANP is predominantly secreted via coronary sinus into the right atrium.
The plasma ANP concentrations of the peripheral and femoral vein, the pulmonary artery and the aorta, especially that of the aorta, correlated well with the atrial pressure, the area and the wall stress. This suggests that the arterial blood may
be
the
most appropriate sample for measurement of the ANP.
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