Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease

Ko Bando, Palaniswamy Vijayaraghavan, Mark Turrentine, Thomas G. Sharp, Gregory J. Ensing, Yasuo Sekine, Laszlo Szekely, Robert J. Morelock, John Brown

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: Pulmonary hypertension causes major morbidity and mortality after congenital heart surgery, but its mechanism remains unclear. Methods and Results: Plasma endothelin-1 (ET-1), nitric oxide (NO), and cyclic OMP (cGMP) were assayed at 6 intervals in 50 children undergoing cardiopulmonary bypass (CPB): before CPB, 10 minutes into CPB, and 0, 3, 6, and 12 hours after CPB. Three groups based on pulmonary flow and pressure were analyzed: low flow (LF, n=21), high flow/low pressure (systolic pulmonary pressure/systemic pressure ratio, Pp/Ps<50%, HF-LP, n= 11), and high flow/high pressure (Pp/Ps≤50%, HF-HP, n=19). HF-HP and HF-LP received α- blockers (chlorpromazine and/or prazosin). HF-HP patients received nitric oxide donors (nitroglycerin/sodium nitroprusside). ET-1 peaked at 6 hours, with its highest level in the HF-HP group (P<.01, by ANOVA). ET-1 correlated significantly with Pp/Ps at 6 hours (R2=.43, P<.005). In the HF-HP group, ET-1 remained above the other groups at 12 hours (12.7±2.5 pg/mL versus 6.4±1.1 pg/mL versus 6.5±3.8 pg/mL P<.05 by ANOVA). NO metabolites were elevated equivalently for the HF-HP and HF-LP groups (5.7±2.6 μmol/L versus 0.3.5±2.5 μmol/L at 12 hours, P=NS) despite nitric oxide donors and the excess ET-1 in HF-HP patients. Levels of cGMP were similarly elevated in HF- HP and HF-LP patients during this study. Conclusions: Endogenous NO may decrease vascular tone and maintain low pulmonary pressure in HF-LP patients. High levels of ET-1, inadequate NO production, and/or impaired responses to NO may increase pulmonary pressure in HF-HP patients.

Original languageEnglish
JournalCirculation
Volume96
Issue number9 SUPPL.
StatePublished - Nov 4 1997

Fingerprint

Cyclic GMP
Endothelin-1
Heart Diseases
Nitric Oxide
Cardiopulmonary Bypass
Pressure
Lung
Nitric Oxide Donors
Analysis of Variance
Prazosin
Chlorpromazine
Nitroglycerin
Nitroprusside
Pulmonary Hypertension
Thoracic Surgery
Blood Vessels
Blood Pressure
Morbidity
Mortality

Keywords

  • Congenital
  • Endothelin
  • Endothelium-derived factors
  • Heart defects
  • Hypertension
  • Pulmonary surgery

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Bando, K., Vijayaraghavan, P., Turrentine, M., Sharp, T. G., Ensing, G. J., Sekine, Y., ... Brown, J. (1997). Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease. Circulation, 96(9 SUPPL.).

Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease. / Bando, Ko; Vijayaraghavan, Palaniswamy; Turrentine, Mark; Sharp, Thomas G.; Ensing, Gregory J.; Sekine, Yasuo; Szekely, Laszlo; Morelock, Robert J.; Brown, John.

In: Circulation, Vol. 96, No. 9 SUPPL., 04.11.1997.

Research output: Contribution to journalArticle

Bando, K, Vijayaraghavan, P, Turrentine, M, Sharp, TG, Ensing, GJ, Sekine, Y, Szekely, L, Morelock, RJ & Brown, J 1997, 'Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease', Circulation, vol. 96, no. 9 SUPPL..
Bando K, Vijayaraghavan P, Turrentine M, Sharp TG, Ensing GJ, Sekine Y et al. Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease. Circulation. 1997 Nov 4;96(9 SUPPL.).
Bando, Ko ; Vijayaraghavan, Palaniswamy ; Turrentine, Mark ; Sharp, Thomas G. ; Ensing, Gregory J. ; Sekine, Yasuo ; Szekely, Laszlo ; Morelock, Robert J. ; Brown, John. / Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease. In: Circulation. 1997 ; Vol. 96, No. 9 SUPPL.
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abstract = "Background: Pulmonary hypertension causes major morbidity and mortality after congenital heart surgery, but its mechanism remains unclear. Methods and Results: Plasma endothelin-1 (ET-1), nitric oxide (NO), and cyclic OMP (cGMP) were assayed at 6 intervals in 50 children undergoing cardiopulmonary bypass (CPB): before CPB, 10 minutes into CPB, and 0, 3, 6, and 12 hours after CPB. Three groups based on pulmonary flow and pressure were analyzed: low flow (LF, n=21), high flow/low pressure (systolic pulmonary pressure/systemic pressure ratio, Pp/Ps<50{\%}, HF-LP, n= 11), and high flow/high pressure (Pp/Ps≤50{\%}, HF-HP, n=19). HF-HP and HF-LP received α- blockers (chlorpromazine and/or prazosin). HF-HP patients received nitric oxide donors (nitroglycerin/sodium nitroprusside). ET-1 peaked at 6 hours, with its highest level in the HF-HP group (P<.01, by ANOVA). ET-1 correlated significantly with Pp/Ps at 6 hours (R2=.43, P<.005). In the HF-HP group, ET-1 remained above the other groups at 12 hours (12.7±2.5 pg/mL versus 6.4±1.1 pg/mL versus 6.5±3.8 pg/mL P<.05 by ANOVA). NO metabolites were elevated equivalently for the HF-HP and HF-LP groups (5.7±2.6 μmol/L versus 0.3.5±2.5 μmol/L at 12 hours, P=NS) despite nitric oxide donors and the excess ET-1 in HF-HP patients. Levels of cGMP were similarly elevated in HF- HP and HF-LP patients during this study. Conclusions: Endogenous NO may decrease vascular tone and maintain low pulmonary pressure in HF-LP patients. High levels of ET-1, inadequate NO production, and/or impaired responses to NO may increase pulmonary pressure in HF-HP patients.",
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T1 - Dynamic changes of endothelin-1, nitric oxide, and cyclic GMP in patients with congenital heart disease

AU - Bando, Ko

AU - Vijayaraghavan, Palaniswamy

AU - Turrentine, Mark

AU - Sharp, Thomas G.

AU - Ensing, Gregory J.

AU - Sekine, Yasuo

AU - Szekely, Laszlo

AU - Morelock, Robert J.

AU - Brown, John

PY - 1997/11/4

Y1 - 1997/11/4

N2 - Background: Pulmonary hypertension causes major morbidity and mortality after congenital heart surgery, but its mechanism remains unclear. Methods and Results: Plasma endothelin-1 (ET-1), nitric oxide (NO), and cyclic OMP (cGMP) were assayed at 6 intervals in 50 children undergoing cardiopulmonary bypass (CPB): before CPB, 10 minutes into CPB, and 0, 3, 6, and 12 hours after CPB. Three groups based on pulmonary flow and pressure were analyzed: low flow (LF, n=21), high flow/low pressure (systolic pulmonary pressure/systemic pressure ratio, Pp/Ps<50%, HF-LP, n= 11), and high flow/high pressure (Pp/Ps≤50%, HF-HP, n=19). HF-HP and HF-LP received α- blockers (chlorpromazine and/or prazosin). HF-HP patients received nitric oxide donors (nitroglycerin/sodium nitroprusside). ET-1 peaked at 6 hours, with its highest level in the HF-HP group (P<.01, by ANOVA). ET-1 correlated significantly with Pp/Ps at 6 hours (R2=.43, P<.005). In the HF-HP group, ET-1 remained above the other groups at 12 hours (12.7±2.5 pg/mL versus 6.4±1.1 pg/mL versus 6.5±3.8 pg/mL P<.05 by ANOVA). NO metabolites were elevated equivalently for the HF-HP and HF-LP groups (5.7±2.6 μmol/L versus 0.3.5±2.5 μmol/L at 12 hours, P=NS) despite nitric oxide donors and the excess ET-1 in HF-HP patients. Levels of cGMP were similarly elevated in HF- HP and HF-LP patients during this study. Conclusions: Endogenous NO may decrease vascular tone and maintain low pulmonary pressure in HF-LP patients. High levels of ET-1, inadequate NO production, and/or impaired responses to NO may increase pulmonary pressure in HF-HP patients.

AB - Background: Pulmonary hypertension causes major morbidity and mortality after congenital heart surgery, but its mechanism remains unclear. Methods and Results: Plasma endothelin-1 (ET-1), nitric oxide (NO), and cyclic OMP (cGMP) were assayed at 6 intervals in 50 children undergoing cardiopulmonary bypass (CPB): before CPB, 10 minutes into CPB, and 0, 3, 6, and 12 hours after CPB. Three groups based on pulmonary flow and pressure were analyzed: low flow (LF, n=21), high flow/low pressure (systolic pulmonary pressure/systemic pressure ratio, Pp/Ps<50%, HF-LP, n= 11), and high flow/high pressure (Pp/Ps≤50%, HF-HP, n=19). HF-HP and HF-LP received α- blockers (chlorpromazine and/or prazosin). HF-HP patients received nitric oxide donors (nitroglycerin/sodium nitroprusside). ET-1 peaked at 6 hours, with its highest level in the HF-HP group (P<.01, by ANOVA). ET-1 correlated significantly with Pp/Ps at 6 hours (R2=.43, P<.005). In the HF-HP group, ET-1 remained above the other groups at 12 hours (12.7±2.5 pg/mL versus 6.4±1.1 pg/mL versus 6.5±3.8 pg/mL P<.05 by ANOVA). NO metabolites were elevated equivalently for the HF-HP and HF-LP groups (5.7±2.6 μmol/L versus 0.3.5±2.5 μmol/L at 12 hours, P=NS) despite nitric oxide donors and the excess ET-1 in HF-HP patients. Levels of cGMP were similarly elevated in HF- HP and HF-LP patients during this study. Conclusions: Endogenous NO may decrease vascular tone and maintain low pulmonary pressure in HF-LP patients. High levels of ET-1, inadequate NO production, and/or impaired responses to NO may increase pulmonary pressure in HF-HP patients.

KW - Congenital

KW - Endothelin

KW - Endothelium-derived factors

KW - Heart defects

KW - Hypertension

KW - Pulmonary surgery

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