Assessment Of Serum BNP,VEGF, And HsCRP On Congenital Systemic To Pulmonary Shunts Heart Disease With Pulmonary Hypertension

Objective:To investigate the relationship between serum brain natriuretic peptide (BNP),vascular endothelial growth factor(VEGF),high-sensitivity C-reactive protein(hsCRP)levels and the patients with congenital systemic to pulmonary shunts heart disease and(or) with pulmonary hypertension on pulmonary arterial pressure, and differences in different parts of the congenital heart disease(CHD) patients,and try to find the non-invasive assessment on the degree of pulmonary arterial pressure, pulmonary artery remodeling and mechanisms of pulmonary hypertension.Methods:41 cases of congenital systemic to pulmonary shunts heart disease and 20 cases of normal control group were involved in the research.The patients with congenital heart disease have been carried out under pre-operative examination of conventional echocardiography,right heart catheterization in parallel.Based on measurements of mean pulmonary arterial pressure with right heart catheterization, the patients were divided into 16 cases of non-pulmonary hypertension group,13 cases of mild to moderate pulmonary hypertension group and 12 cases of severe pulmonary hypertension group.All patients were took peripheral vein and pulmonary artery blood each 4ml,ASD patients with pulmonary vein blood 4ml,PDA patients with aortic valve blood 4ml.Application of enzyme-linked immunosorbent assay (ELISA) determinate the serum samples of patients with BNP,VEGF,and hsCRP levels,to analysis the relationship of different degree of pulmonary arterial pressure and the different parts of the patients,and pulmonary artery remodeling. Results:1.Congenital systemic to pulmonary shunts heart disease serum BNP,VEGF,and hsCRP levels are significantly higher than normal group,and BNP,VEGF levels and the degree of pulmonary arterial pressure is linearly related.Serum BNP,VEGF levels to determine the extent of pulmonary hypertension have higher accuracy.2.The serum BNP,VEGF levels of ASD and PDA patients in pulmonary artery, pulmonary vein and above aortic valve were significantly higher than the peripheral vein,and there was no difference between pulmonary artery,pulmonary vein and above aortic valve;there was no difference aboat the serum hsCRP levels in peripheral veins,pulmonary artery,pulmonary vein and above aortic valve.3.The serum BNP,VEGF levels in group of congenital systemic to pulmonary shunts heart disease with resistance pulmonary hypertension were higher than the dynamic pulmonary hypertension group,and no significant difference in levels of hsCRP.4.Doppler echocardiography can be used as estimation of pulmonary artery systolic pressure of more reliable indicator,which assess accurately in congenital systemic to pulmonary shunts heart disease with mild to moderate pulmonary hypertension,but in patients without pulmonary hypertension often overestimate and severe pulmonary hypertension is underestimated.Conclusion:The level of serum BNP,VEGF and hsCRP can more accurate assessment of congenital systemic to pulmonary shunts heart disease,the degree of pulmonary hypertension and pulmonary arterial remodeling and peripheral vein serum BNP,VEGF levels do not reflect the true level of pulmonary circulation,and the BNP, VEGF enter and out lung had no difference in the level.Echocardiography to estimate pulmonary artery pressure can be used as a more reliable indicator.There was inflammatory response in patients with congenital systemic to pulmonary shunts heart disease and(or) with pulmonary hypertension and VEGF may be involved in the occurrence of pulmonary hypertension.