Document Detail


Prognostic significance and correlations of neurohumoral factors in early and late postoperative period after Fontan procedure.
MedLine Citation:
PMID:  21422153     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We focused on neurohumoral activity and its clinical correlates early and late after fenestrated, lateral intra-atrial total cavopulmonary connection (TCPC). Between 2007 and 2010, we prospectively studied 28 early and 48 late postoperative TCPC patients. Plasma concentrations of vasopressin, endothelin-1, proBNP, proANP were determined. We reviewed clinical data to determine relationship between neurohumoral activation and clinical status after TCPC. There was a significant influence of preoperative ventricular end-diastolic pressure (VEDP) (P=0.008) and vasopressin concentration (P=0.02) on the appearance of prolonged pleural effusions. A significant correlation between a combined predictor (a product of preoperative vasopressin concentration and VEDP) and time of effusions (r=0.59, P=0.006) was found. The mean respiratory equivalent of carbon dioxide at peak exercise (VE/VCO2peak) was significantly lower in patients operated before the second year of life compared to patients operated after two years of age (27.5±1.39 vs. 48.6±3.86; P=0.039). There was a significant correlation of endothelin-1 (r=0.84; P=0.008) and proBNP (r=0.88; P=0.02) concentrations with VE/VCO2peak. The prolonged postoperative pleural effusions can be predicted based on the product of preoperative vasopressin concentration and VEDP. Exercise performance is related to the age at TCPC. Endothelin-1 and proBNP can be useful for identification of high-risk Fontan patients. Keywords: Single ventricle defects; Fontan circulation; Neurohormonal activation; Exercise capacity.
Authors:
Jacek Kolcz; Lidia Tomkiewicz-Pajak; Elzbieta Wojcik; Piotr Podolec; Janusz Skalski
Related Documents :
1221553 - A community survey of asthmatic characteristics.
3693013 - Evaluation of a stented laryngoplasty for correction of cranial glottic stenosis in fou...
2565233 - The acute effects of intravenous xamoterol ('corwin', i.c.i. 118, 587) on resting and e...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-21
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  -     ISSN:  1569-9285     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Krakow, Poland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Endogenous IL-33 enhances Th2 cytokine production and T-cell responses during allergic airway inflam...
Next Document:  Giant solitary fibrous tumor of the pleura.