The Level Of The Serum CA,ALD In Children Congenital Heart Disease And The Correlation Between The CA,ALD And Cardiac Function

[Objective]To investigate the level of serum catecholamine and aldosterone in children with left to right shunt congenital heart disease(CHD),analyze the correlation between the serum catecholamine,aldosterone and cardiac function,ventricular volume load,pulmonary artery pressure and heart remodeling.The aim to do this is to make an objective parameter for assessment the cardiac function,help us to understand hemodynamics state of CHD patient more clearly and aid us to choose the optimal treatment opportunity and method in clinical practice.[Method]1.53 cases of left to right shunt congenital heart disease included ventricular septal defect,atrial septal defect and patent ductus arteriosus in hospital were enrolled from the patients in the Cardiology Dept.of Tianjin Children's hospital and diagnosed by color Doppler ultrasound.20 cases of control group which had normal blood Rt.,ECG and X-ray check and had no deviation in the age and sex were selected from the patients in the prevent surgery.2.We adopted the ELISA method to measure the content of serum catecholamine and aldosterone in the patients of the contrast group and the patient group.We divided the patient group into two groups,which were named large shunt group and small shunt group according to the ratio of pulmo and systemic circulation.We classified the patient group into two groups,which were named heart failure group and non-heart failure group and divided the patient group into two groups,which were named pulmonary artery hypertension group and non-pulmonary artery hypertension group according to the mean pressure of pulmonary artery.3.We applied the Philips iE33 type Echocardiogram to measure the left atrium diameter(LAD),left ventricular end systolic inner diameter(LVESD),left ventricular end diastolic inner diameter(LVEDD),end-systolic wall thickness of the left ventricular,left ventricular end diastolic volume(LVEDV) and so on,calculated left atrium diameter index(LADI),left ventricular end diastolic inner diameter index(LVEDDI),left ventricular end diastolic volume index (LVEDVI),LVFS,LVEF,CI,mean pulmonary artery pressure,ratio of pulmo and systemic circulation(Qp/Qs),left ventricular end-systolic wall stress(LVESWS)and left ventricular mass index(LVmassI).4.We analysis all the datum with SPSS11.5 For Windows.[Result]1.The serum NE and ALD in patient group is higher than the contrast group (p＜0.01).The serum NE and ALD is higher in heart failure group than in non-heart failure group(p＜0.01).The serum NE and E is higher in large shunt group than in small shunt group(p＜0.01).The serum NE and ALD is higher in pulmonary artery hypertension group than in non-pulmonary artery hypertension group(p＜0.05).2.The left ventricular end diastolic inner diameter index,left ventricular mass index of heart failure group are larger than those of non-heart failure group(p＜0.01).There have no statistical significantly difference in LVFS,LVEF and left ventricular end-systolic wall stress between the heart failure group and non-heart failure group(p＞0.05).3.There is one kind of positive rank correlation between the serum level of CA and left atrial diameter index(p＜0.01)and left ventricular end diastolic diameter index(p＜0.01)and left ventricular end diastolic volume index(p＜0.01).[Conclusion]1.The serum NE and ALD in children with left to right shunt congenital heart disease is increased significantly.2.The serum NE and ALD in heart failure group is higher than that of non-heart failure.The serum NE and ALD may be done as an objective parameter in the diagnosis of heart failure.3.The serum NE and ALD is higher in pulmonary artery hypertension group than in non-pulmonary artery hypertension group.The serum NE and ALD may be a biological parameter in discovery of pulmonary artery hypertension earlier.4.There is a positive rank correlation between the serum CA and left atrial diameter index,left ventricular end diastolic diameter index and left ventricular end diastolic volume index.Monitor the level of CA will help us find adverse myocardial remodeling earlier and begin treatment immediately to prevent developing heart failure.