Abstract：Objective To investigate the changes in plasma levels of atrial natriuretic peptide (ANP), endothelin-1 (ET-1) and von Willebrand factor (vWF), and their significance among newborns with persistent pulmonary hypertension (PPH). Methods Sixty-six newborns with PPH (case group) (mild: 26 cases; moderate: 21 cases; severe: 19 cases), as well as 40 newborns without PPH (control group) who were hospitalized in the same period, were enrolled. The control group underwent echocardiography on admission. The case group underwent echocardiography before treatment (with refractory hypoxemia) and after 7 days of treatment for measurement of pulmonary artery systolic pressure (PASP). Meanwhile, plasma levels of ANP, ET-1 and vWF were measured using ELISA. Results Before treatment, the case group had significantly higher plasma levels of ANP, ET-1 and vWF than the control group (P<0.05), and these indices increased as PASP rose. After 7 days of treatment, the children with mild or moderate PPH showed normal PASP, and their plasma levels of ANP, ET-1 and vWF were not significantly different from those of control group. The children with severe PPH had significant decreases in all indices, but they were significantly higher than those of the control group. Plasma levels of ANP, ET-1 and vWF were significantly positively correlated with PASP before and after treatment (P<0.01). Conclusions Changes in plasma levels of ANP, ET-1 and vWF can reflect PASP in newborns with PPH during treatment. Dynamic monitoring of these indices can help to judge the severity of PPH and guide treatment.
YAO Ai-Min,HAO Ya-Ping,ZHANG Jie et al. Changes in plasma levels of atrial natriuretic peptide, endothelin-1 and von Willebrand factor among newborns with persistent pulmonary hypertension[J]. CJCP, 2013, 15(9): 718-722.
Abman SH. Recent advances in the pathogenesis and treatment of persistent pul-monary hypertension of the newborn［J］. Neonatology, 2007, 91(4): 283-290.
Kangawa K, Matsuo H. Purification and complete aminoaeid Sequence of alpha-human atrial natriuretic polypeptide(alpha-hANP)[J]. Biochem Biophys Res Commun, 1984, 118(1): 131.
[9]
Vaz Perez A, Doehner W, Von Haehling S. The relationship between tumor necrosis factor-α, brain natriuretic peptide and atrial natriuretic peptide in patients with chronic heart failure[J]. Int J Cardiol, 2010, 141 (1): 39-43.
[10]
Gerczuk PZ, Kloner RA. An update on cardioprotection a review of the latest adjunctive therapies to limit myocardial infarcction size in clinical trials[J]. J Am Coll Cardiol, 2012, 59 (11): 970-978.
[11]
Koga H, Hagiwara S, Kusaka J, Matsumoto S, Nishida T, Yokoi I, et al. Human atrial natriuretic peptide attenuates renal ischemia-reperfusion injury[J]. J Surg Res, 2012, 173(2): 348-353.
[12]
Krishnan U. Management of Pulmonary Arterial Hypertension in the Neonatal Unit[J]. Cardiol Rev, 2010, 18(2): 73-75.
Giaid A, Yanagisawa M, Langleben D. Expression of endothelin-1 in the lungs of patients with pulmona hypertension[J]. N Engl J Med, 1993, 328(24): 1732-1739.
Lopes AA, Barreto AC, Maeda NY, Cicero C, Soares RPS, Bydlowski SP. et al. Plasma von Willebrand factor as a predictor of survival in pulmonary arterial hypertension associated with congenital heart disease[J]. Brazil J Med Biol Res, 2011, 44(12): 1269-1275.
[21]
Alian Z, Hashemipour M, Dehkordi EH, Hovsepian S, Amini M, Moadab MH, et al. The effects of folic acid on markers of endothelial function in patients with type1 diabetes mellitus[J]. MED ARH, 2012, 66(2): 12-15.
[22]
Vischer UM. von Willebrand factor, endothelial dysfunction, and cardiovascular disease[J]. Thromb Haemost, 2006, 4(11): 86-93.
