Plasma endothelin-1, homocysteine and serum nitric oxide values in patients with left-to-right shunt.
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.
Ozerol
Ibrahim H
IH
Department of Clinical Microbiology, Pediatrics, Biochemistry, Cardiovascular Surgery and Biostatistics, Faculty of Medicine, Inonu University, Malatya, Turkey. iozerol@inonu.edu.tr
Pac
Feyzanur A
FA
Ozerol
Elif
E
Ege
Erdal
E
Yologlu
Saim
S
Temel
Ismail
I
Pac
Mustafa
M
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
D015415:Biomarkers; D019332:Endothelin-1; D006710:Homocysteine; D009569:Nitric Oxide