Japan Society for the Promotion of Science:Grants-in-Aid for Scientific Research
Date (from‐to) : 2006 -2007
Author : TAKEDA Yutaka; MISHIMA Akira; OHTE Nobuyuki; ASANO Miki; DOHI Yasuaki; MIZUNO Kantaro
We enrolled 20 patients with congenital heart disease who are 15 years ole and older to this investigation. NYHAfunctional class were2.4±0.6, and exercise tolerance defined with Specific Activity Scale questionnaire was 5.1±1.3 METs. Univariate regression analyses found that plasma concentrations of endothelin-1(standardized correlation coefficient [β]=-0.446,P=0.049), uninary norepinephrine concentraion (β=-0.536, P=0.015), and urinary biopyrrin concentration (β=-0.535, P=0.015) were inversely correlated with exercise capacity. There was a trend that exercise capacity of the patients with SpO2 <90% were less than that of those with 90% or more (β=0.396, 1:=0.084). Unexpectedly, strong positive correlation was found between exercise capacity and plasma concentration of brain natriuretic peptide. A multivariate regression analysis with forward stepwise selection of variable found that presence of hypoxia (β=-0.439, P=0.023) and urinary concentration of norepinephrine (β=-0.569, P=0.005) were independent predictors of exercise tolerance. A strong positive correlation was noted between urinary norepinephrine and biopyrrin (β=0.806, F<0.001). This study demonstrated that urinary levels of norepinephrine and biopyrrin and plasma level of endothelin-1 but not that of brain natriuretic peptide were available for marker of severity of congenital heart disease in adult patients. The strong correlation in urinary levels between norepinephrine and biopyrrin suggests antioxidation and sympatholysis are potential approach to management of patients with adult congenital heart disease.