No inflammatory response related to pulmonary hemodynamics in children with systemic to pulmonary shunts.

Abstract

OBJECTIVE:

The hypothesis was that the levels of circulating inflammatory mediators are related to the degree of volume and pressure stress on the pulmonary vasculature in children with congenital systemic to pulmonary shunts.

DESIGN:

Prospective, cross-sectional study.

SETTING:

Tertiary center covering all pediatric heart surgery and interventions in Norway.

PATIENTS:

Seventy-four children, aged 0-12 years, admitted for surgical or interventional treatment of congenital systemic to pulmonary shunts.

OUTCOME MEASURES:

Plasma levels of eight mediators of vascular inflammation and endothelial activation, sampled from different vascular compartments.

RESULTS:

Patients with the most pronounced pulmonary flow and pressure stress demonstrated no elevation of inflammatory mediator levels when compared with healthy controls. No pulmonary production or uptake of the measured markers was found. Hemodynamic explanatory factors showed weak correlations to the inflammatory marker levels by univariate analysis. Age was the only factor that significantly explained inflammatory response in the multivariate model. The presence of Down syndrome, irrespective of hemodynamic category, was associated with elevated plasma levels of soluble tumor necrosis factor receptor I, when controlling for age.

CONCLUSIONS:

Inflammatory mediators show no significant relationship to pulmonary hemodynamics in children with systemic to pulmonary shunts. Children with Down syndrome may have an increased inflammatory response.

• Authors: Henrik Brun, Thor Ueland, Erik Thaulow, Jan K Damas, Arne Yndestad, Pal Aukrust, Henrik Holmstrøm
• Journal: Congenital heart disease (Congenit Heart Dis) 2011 Jul-Aug Vol. 6 Issue 4 Pg. 338-46 ISSN: 1747-0803 [Electronic] United States
• PMID: 21450032 (Publication Type: Journal Article)
• Copyright: © 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.

Chemical References

• Inflammation Mediators

Topics

• Age Factors
• Blood Pressure
• Case-Control Studies
• Child
• Child, Preschool
• Cross-Sectional Studies
• Down Syndrome (immunology, physiopathology)
• Endothelium, Vascular (immunology)
• Female
• Heart Defects, Congenital (complications, immunology, physiopathology, therapy)
• Hemodynamics
• Humans
• Infant
• Infant, Newborn
• Inflammation (etiology, immunology, physiopathology)
• Inflammation Mediators (blood)
• Linear Models
• Male
• Norway
• Prospective Studies
• Pulmonary Circulation
• Risk Assessment
• Risk Factors