Correlation between Plasma Adiponectin Levels and Mean Pulmonary Artery Pressure Amongst Grown-Up Uncorrected Atrial Septal Defect
Author : W. Himawan, D. W. Anggrahini, A. B. Hartopo, L.K. Dinarti
Upload Date : 19-04-2018
Background. Atrial septal defect (ASD) has become the most common congenital heart defect found in adults. The natural course of uncorrected ASD is to develop into pulmonary artery hypertension (PAH) wth various severity that might influence quality of life, mortality, and morbidity. Pulmonary artery hypertension pathogenic mechanism are complex and involve abnormal vasoconstriction and cell proliferation, increased inflammation, and thrombosis in situ, amongst others, and previous studies has linked its mechanism with adiponectin. However, the role of adiponectin in mean pulmonary arteria pressure (mPAP) increase is still unknown. The present study assessed plasma adiponectin levels and mPAP in uncorrected secundum ASD patients.
Methods. A cross-sectional study was conducted in grown-up, uncorrected secundum ASD registered in ASD Registry of Dr Sardjito Hospital. We characterized the clinical features, functional status, body mass index (BMI), and transcutaneous oxygen saturation. We measured echocardiographic features (defect diameter, shunt direction, right ventricle function) and haemodynamic features (mean pulmonary artery pressure, flow ratio, and pulmonary vascular resistance). Venous blood sampling were drawn and plasma adiponectin level were measured using ELISA technique.
Results. Amongst 87 grown-up, uncorrected secundum ASD patients, 96% patients had PAH, and 34% had eisenmenger syndrome. No significant correlation was found between plasma adiponectin level and mean pulmonary artery pressure (p = 0.098). Adiponectin levels in PAH patients were not significantly differ from non-PAH patients (p = 0.353), nor with eisenmenger and non-eisenmenger syndrome (p = 0.636).
Conclusion. Plasma adiponectin levels were not statistically significant correlates with mean pulmonary artery pressure in grown-up, uncorrected ASD patients.
KEYWORDS : congenital heart defect; atrials septal defect; pulmonary artery hypertension; pulmonary vascular remodeling; adiponectin; plasma adiponectin level.