Çetin Güvenç Rengin, Koç Ada Saniye, Güvenç Tolga Sinan, Çelik Fatma Betül, Polat Ocaklı Ezgi, Al Arfaj Abdullah Ayar, Güllü Hakan, Özer Nihat, Çekmen Mustafa Baki, Çalışkan Mustafa
Okan Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Tepeören Mahallesi Tuzla Kampüsü, İstanbul Okan Üniversitesi, 34959, Tuzla, İstanbul, Turkey.
Biyokimya Anabilim Dalı, Medeniyet Üniversitesi Tıp Fakültesi, İstanbul, Turkey.
Sci Rep. 2024 Dec 2;14(1):29980. doi: 10.1038/s41598-024-78950-x.
Atrial septal defects (ASD) divert flow from systemic to pulmonary circulation, and some degree of plasma volume expansion and neurohormonal activation are necessary to maintain the effective circulatory volume. The aim of the present study was to understand the patterns of neurohormonal activation in ASD patients. 16 ASD patients and 10 controls were enrolled. Fasting blood samples were collected prior to procedure and 48 h after defect closure. At baseline, renin (185.0(79.0-437.0 vs. 79.4(60.8-110.0), p = 0.04), aldosterone (20.2 ± 7.6 vs. 11.7 ± 2.8, p < 0.001), copeptin (43.6 ± 27.5 vs. 16.4 ± 8.7, p = 0.002) and both natriuretic peptides were higher in ASD patients, while noradrenaline (113.0 ± 61.3 vs. 178.0 ± 49.4, p = 0.009) and endothelin-1 (2.93 ± 2.00 vs. 5.06 ± 1.25, p = 0.006) were higher in controls. After ASD closure, only NT-proBNP reduced significantly (p = 0.02). There were negative correlations between defect area with noradrenaline (r=-0.73, p = 0.002) and with endothelin-1 (r=-0.59, p = 0.02). Present findings suggest that in patients with an ASD, there is an increase in neurohormones that are related to regulation of plasma volume (aldosterone and arginine vasopressin) with simultaneous reductions in neurohormones related to vasoconstriction in systemic and pulmonary beds (noradrenaline and endothelin-1).
房间隔缺损（ASD）使血流从体循环分流至肺循环，一定程度的血浆容量扩张和神经激素激活对于维持有效循环血量是必要的。本研究的目的是了解ASD患者神经激素激活的模式。纳入了16例ASD患者和10例对照。在手术前和缺损关闭后48小时采集空腹血样。基线时，ASD患者的肾素（185.0(79.0 - 437.0) 对比 79.4(60.8 - 110.0)，p = 0.04）、醛固酮（20.2 ± 7.6 对比 11.7 ± 2.8，p < 0.001）、 copeptin（43.6 ± 27.5 对比 16.4 ± 8.7，p = 0.002）以及两种利钠肽均较高，而对照组的去甲肾上腺素（113.0 ± 61.3 对比 178.0 ± 49.4，p = 0.009）和内皮素 - 1（2.93 ± 2.00 对比 5.06 ± 1.25，p = 0.006）较高。ASD关闭后，仅NT - proBNP显著降低（p = 0.02）。缺损面积与去甲肾上腺素（r = -0.73，p = 0.002）和内皮素 - 1（r = -0.59，p = 0.02）之间存在负相关。目前的研究结果表明，在ASD患者中，与血浆容量调节相关的神经激素（醛固酮和精氨酸加压素）增加，同时与体循环和肺循环血管收缩相关的神经激素（去甲肾上腺素和内皮素 - 1）减少。
