The Relation Between The Level Change Of Ghrelin And The Cardiac Function Before And After Interventional Therapy In Patients With Ventricular Septal Defect

Purpose:Growth hormone releasing peptide is associated with various cardiovascular diseases,and has the effects of preventing myocardial cell apoptosis,dilating blood vessels,enhancing myocardial contractility,inhibiting sympathetic nerve excitability,reversing ventricular remodeling and so on.This study aimed to observe that,combined with echocardiography,if the changes of Ghrelin levels before and after transcatheter closure of ventricular septal defect can effectively evaluate VSD patients’ cardiac hemodynamics,ventricular remodeling and cardiac function.Method: Thirty-threen VSD patients,aged 3-14 years old,17 males and16 females,were successfully treated by intervetional therapy in the first hospital of Hebei Medical University Department of Cardiology from August2015 to August 2016 and selected as VSD group.Thirty healthy children,aged3-14 years old,16 males and 14 females,came from the Heaith examination center of the first hospital of Hebei Medical University were enrolled as the control group.Relevant information were collected and the same to venous blood.The vital signs,cardiac murmur,arrhythmia and complications were observedon and the echocardiography were exzminened.RVTD,RATD,LAAD,LVEDD,LVESD,LVEDV,LVESV,SV,EFwere recorded before operation and 5 days,1,3,6 months after the intervetion.SPSS 21.0 software was used for statistical analysis.Result:1 The growth and development of children:The VSD group and control group had no difference in age(5.46±2.74 years vs 5.95±3.03 years,P>0.05)and sex(P>0.05).The height(107.01±8.41)cm and body weight(16±5.60)kg of children in VSD groupwere slightly lower than that of normal children(116.79±9.64)cm,weight(21.22±5.07)kg,P<0.05.2 The change of serum Ghrelin:The serum Ghrelin of VSD group(8.26±1.15ng/ml)was significantly higher than that in control group(3.57±1.43ng/ml,P<0.05).The Ghrelin concentration decreased gradually at 5 days,1,3 months after operation,even to the normal level at 6 months(3.48±1.36ng/ml)after operation.3 The changes of atrioventricular structure and cardiac function:The index of echocardiography in VSD group: RVTD,LAAD,LVEDD,LVESD,LVEDV,LVESV,SV gradually decreased at 5 days,1,3,6 months after the operation comparaed with preoperation.However,RATD and EF had no significance before and after intervention.4 The relationship between Ghrelin and ventricular remodeling:The Pearson correlation analysis showed that there was a positive relationship between the changes of Ghrelin and RVTD(r=0.991,P<0.001),LAAD(r=0.979,P<0.001),LVEDD(r=0.745,P<0.001),LVESD(r=0.404,P<0.01),LVEDV(r=0.982,P<0.001),LVESV(r=0.989,P<0.001),SV(r=0.965,P<0.001)before and after the intervention.No relation with RATD(r=0.216,P>0.05),EF(r=0.202,P>0.05).Conclusion:The preoperative Ghrelin level of children in VSD group was higher than in control group.Then the Ghrelin concentration decreased to normal at 6months after the operation.The structure of left atrial,left ventricle and right ventricle were reversed after operation in patients with ventricular septal defect.Both of the changes are identical in trend and significant in Statistic.So the change of Ghrelin level may be an indirect evvaluation index for abnormal hemodynamic correction,improvement of atrioventricular structure and improvement of cardiac function after interventional therapy in VSD children.