title: The role of plasma endothelin in the Fontan circulation.
abstract: BACKGROUND
  Various vasoactive substances are released during cardiopulmonary bypass. They may deteriorate pulmonary circulation after the Fontan operation. Effects of plasma endothelin-1 (ET-1), a vasoconstricting peptide, on the Fontan circulation have not been investigated.
  
  
  METHODS
  Eleven patients (aged 11.1+/-7.5 years) who underwent the modified Fontan operation (group F) and seven patients (aged 9.9+/-6.0 years) who underwent the biventricular repair (group C) were studied. Plasma samples were obtained for measuring ET-1 on the first postoperative day (Early I), on returning to floor care from the intensive care unit (Early II), and during postoperative cardiac catheterization (Late).
  
  
  RESULTS
  Plasma concentrations of ET-1 increased in group F (Early I, 4.37+/-1.78 pg/ml; Early II, 4.07+/-1.90 pg/ml) as compared with the basal value of 1.0+/-0.5 pg/ml. The central venous pressure, which reflects the pulmonary circulatory state, soon after the Fontan operation correlated significantly with the increased ET-1 concentration (y=1.809 x+6.484; r=0.809; p=0.0026). Although the Late ET-1 concentrations in group F were significantly decreased, the central venous pressure and the ET-1 concentrations demonstrated a significant correlation (y=3.074 x +5.427; r=0.740; p=0.0227).
  
  
  CONCLUSIONS
  The increased humoral vasoactive substances such as ET-1, which induces pulmonary vasoconstriction following the Fontan operation, may have important implications for the Fontan circulation.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan. myama@koto.kpu-m.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Yamagishi
authors.forename: H
authors.initials: H
authors.lastname: Kurosawa
authors.forename: K
authors.initials: K
authors.lastname: Hashimoto
authors.forename: K
authors.initials: K
authors.lastname: Nomura
authors.forename: N
authors.initials: N
authors.lastname: Kitamura
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D002315:Cardiopulmonary Bypass / Q000379:methods*; D016022:Case-Control Studies; D002496:Central Venous Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000379:methods*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011379:Prognosis; D011652:Pulmonary Circulation / Q000502:physiology*; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019332:Endothelin-1