Plasma cyclic 3',5'-adenosine monophosphate in patients with elevated pulmonary pressure due to left-to-right shunt.

BACKGROUND

Increased pulmonary blood flow in patients with left-to-right shunt has been shown to be associated with alterations in prostacyclin-synthesis. There are limited data with respect to the plasma cAMP in patients with elevated pulmonary artery pressure due to left-to-right shunt. We hypothesized that plasma cAMP might be influenced by pulmonary blood flow or pressure in patients with left-to-right shunt.

METHODS

Plasma cAMP from venous blood was measured in 122 healthy controls aged 8.3 (0.2 - 14.9) years (median [range]) and in 130 patients with left-to-right shunt aged 1.4 (0.1 - 19.1) years by radioimmunoassay.

RESULTS

Plasma cAMP in controls and in patients was similar and decreased with age. Healthy infants (n = 42) showed higher plasma cAMP (46 [27-112] nmol/l) than children > 6 years of age (n = 40, 39 [19-73] nmol/l; P < 0.001).

CONCLUSIONS

These values should be taken into consideration when reporting plasma values for cAMP in patients with congenital heart disease. The values for healthy children obtained in this study should allow a better interpretation of plasma cAMP levels in various disease conditions such as chronic renal failure, liver chirrhosis, hyperthyreosis, or children with intellectual disability.