Correlation of Blood Nitric Axide Level and Right Ventricular Systolic Function in Adult Patient with Uncorrected Secundum Atrial Septal Defect
Author : F. S. A. Pradana, D.W. Anggrahini , A.B. Hartopo, L.K. Dinarti
Upload Date : 19-04-2018
Background. Atrial septal defect (ASD) is one of the most common congenital heart defect found in grown-adult. Uncorrected ASD in adult eventually will develop into right heart failure due to volume overload in right heart chambers. This state in the long run could result in reduced RV compliance and increased right heart chambers pressure. Changes in intravascular pulmonary pressures, pulmonary vascular tone, and vascular wall composition could be happen through diminished nitric oxide availability in these structures which hypothesized will contribute in reduction of right ventricular systolic function. The present study assessed right ventricular systolic function in association with plasma nitric oxide level in uncorrected secundum ASD patients.
Methods. A cross sectional study was orchestrated in adult, uncorrected secundum ASD patient registered in ASD Registry of Dr Sardjito General Hospital. Echocardiographic structural (diameter defect, shunt direction, right ventricle function calculated in TAPSE with cut of < 18 for diminished right ventricular function) and haemodynamic (mean pulmonary artery pressure, flow ratio, and pulmonary vascular resistance) parameters were measured by RHC. Plasma NO level were measured using pulmonary artery blood sampling conducted with ELISA technique.
Result. 97% of 76 patient with uncorrected secundum ASD patient analyzed had PAH. No significant correlation was obtained between NO level and mean pulmonary artery level (p = 0.18). Hence, no significant correlation was found between Nitric Oxide level and right ventricular function calculated in TAPSE (p = 0.83)
Conclusion. Plasma nitric oxide level were not statistically significant correlated with right ventricular systolic function in adult patients with uncorrected ASD.
KEYWORDS : atrial septal defect; right ventricular function; pulmonary arterial hypertension; nitric oxide; tapse; plasma nitric oxide.