Changes Of Urotensin Ⅱ And Its Relationships With Heart Functions In Pneumonia Complicated With Heart Failure

Background and objectivesPneumonia is a common disease in pediatrics. Till now pneumonia is one of the most common infectious diseases leading to death of children. Heart failure is a complication of severe pneumonia, which can lead to significantly higher death rate. Urotensin II (U II) is one type of vasoactive peptide discovered recently. Various studies across the world have confirmed that U II can change the blood dynamics and heart function, and can promote the reorganization of heart muscles and blood vessels, therefore participates in the pathophysiological process of heart failure.This project aims to find the correlations of the levels of U II and the heart functions in the patients that are affected with pneumonia complicated with heart failure. We measured the levels of U II and cTnI in the infant patients that are affected with pneumonia with the heart failure complication, before and after the treatment, and compared these levels with the parameters of heart function obtained from ultrasonography. As a control experiment, we also measured and compared the levels of U II in the infant patients during the process of pneumonia with heart failure complication with those of the healthy children. This study will allow us to gain insight of the functions of U II in the development of pneumonia complicated with heart failure and provide important parameters that could lead to accurate early diagnostics of this severe disease. It will also provide theoretical guidance for earlyinterference treatment of pneumonia complicated with heart failureMethods30 sampled were taken from infants patients with pneumonia complicated with heart failure, infants patients with common pneumonia and normal infants, respectively. The contents of UII in the plasma were determined by radioimmunoassay, cTnI and CK-MB were measured, too. The levels of U II, cTnI and CK-MB were determined again in 20 infants patients with pneumonia complicated with heart failure after the treatment. Ejection fraction (EF), fractional shortening (FS), peak flow velocity of aorta (PFVA) and peak flow velocity of pulmony artery (PFVP) were measured by Doppler ultrasonography.. Results1. In the control normal group, the concentrations of Plasma U II in males are 3.92 ± 0.54 pg/ml, and in females are 3.86±0.54pg/ml, t = 0.29, p>0.05. The correlation of the concentration of plasma U II and age is also studied, r = - 0.255, p>0.05. The concentration of Plasma U II has no direct correlation to sex and age.2. The U II level from the group of pneumonia complicated with heart failure was significantly higher than those from the group of common pneumonia and the normal group. There is no significant difference between the common pneumonia group and the normal group.3. After treatment, the plasma U II level in infants with pneumonia complicated with heart failure decreased significantly, P < 0.01.4. Before treatment, U II correlates negatively with EF, FS, PFVA, PFVP, the r values are -0.761, -0.732, -0.658, -0.733, respectively, P<0.01. U II correlates positively with cTnI and CK-MB, the r values are 0.861, 0.862, respectively, p<0.01.5. When infants with pneumonia complicated with heart failure are compared with the infants with common pneumonia and the normal infants, the EF, FS, PFVA, PFVP decreased significantly, P<0.05. When the infants with common pneumonia are compared with the normal infants, there is no significant difference, P>0.05. The EF, FS, PFVA, PFVP all increase significantly after treatment, p<0.01. 6. When infants with pneumonia complicated with heart failure are compared with infants with common pneumonia and the normal infants, the cTnI, CK-MB levels are significantly higher, P<0.05. There is no significant difference between the infants with pneumonia and the normal infants, P>0.05. In the group of patients with pneumonia complicated with heart failure, the cTnI, CK-MB levels decrease significantly after treatment, p<0.01. Before treatment, cTnI correlates positively with CK-MB, r=0.852, p<0.01. Conclusions1. We found that the concentrations of plasma U II from infants with pneumonia complicated with heart failure increase compared to those of the normal children. After treatment the plasma U II decreases significantly. This indicates that UII is involved in the pathophysiology of pneumonia complicated with heart failure.2. The concentration of plasma U II from patients with pneumonia complicated with heart failure has a negative correlation with the parameters of heart functions and a positive correlation with cTnI. The concentration of plasma U II reflects the level of heart function.3. The concentration of cTnI increases in patients with pneumonia complicated with Heart failure. The concentration of cTnI correlates negatively with the parameters of heart function. After treatment, the cTnI decreases along with improvements of the heart function. This indicates that the mechanism of the pneumonia complicated with heart failure is related to myocardial damage.4. The concentration of plasma U II correlates positively with cTnI. The increase of U II in patients with pneumonia complicated with heart failure is related to myocardial damage.5. Measurement of the concentrations of plasma U II and cTnI will help the diagnosis of the pneumonia complicated with heart failure and prediction of the recovery after treatment.