title: Plasma endothelin-1, homocysteine and serum nitric oxide values in patients with left-to-right shunt.
abstract: BACKGROUND
  This study aimed to evaluate the effect of pulmonary blood flow and pulmonary hypertension on plasma endothelin-1, homocysteine and serum nitric oxide levels in patients with left-to-right shunt lesions with pulmonary hypertension and also with normal pulmonary arterial pressure.
  
  
  RESULTS
  Plasma endothelin-1, homocysteine and nitric oxide levels were measured in 44 patients (Group 1) with left-to-right shunt and normal pulmonary arterial pressure (Qp/Qs: 2.1), 65 patients (Group 2) with left-to-right shunt and pulmonary hypertension (Qp/Qs: 2.4), 20 healthy control subjects (Group 3), and 17 post-operative patients (Group 4). Plasma endothelin-1 and serum nitric oxide levels were significantly higher in Group 2 than in groups 1, 3, and 4 (p<0.001). Plasma homocysteine levels were significantly higher in Group 2 than in Groups 1 and 4 (p<0.001 and p<0.01, respectively).
  
  
  CONCLUSIONS
  The increase in serum nitric oxide levels in patients with left-to-right shunt and pulmonary hypertension may be attributed to the compensatory mechanism. However, this increase does not improve pulmonary hypertension because of increased endothelin-1 and homocysteine levels. In the light of present study, we conclude that vascular changes caused by increased homocysteine and endothelin-1 may provoke pulmonary hypertension in patients with left-to-right shunt.
authors.affiliation: Department of Clinical Microbiology, Pediatrics, Biochemistry, Cardiovascular Surgery and Biostatistics, Faculty of Medicine, Inonu University, Malatya, Turkey. iozerol@inonu.edu.tr
authors.forename: Ibrahim H
authors.initials: IH
authors.lastname: Ozerol
authors.forename: Feyzanur A
authors.initials: FA
authors.lastname: Pac
authors.forename: Elif
authors.initials: E
authors.lastname: Ozerol
authors.forename: Erdal
authors.initials: E
authors.lastname: Ege
authors.forename: Saim
authors.initials: S
authors.lastname: Yologlu
authors.forename: Ismail
authors.initials: I
authors.lastname: Temel
authors.forename: Mustafa
authors.initials: M
authors.lastname: Pac
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002675:Child, Preschool; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood*; D008297:Male; D009569:Nitric Oxide / Q000097:blood
chemical_list: D015415:Biomarkers; D019332:Endothelin-1; D006710:Homocysteine; D009569:Nitric Oxide