PMID- 14597592
OWN - NLM
STAT- MEDLINE
DCOM- 20031208
LR  - 20161124
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 108
IP  - 19
DP  - 2003 Nov 11
TI  - Stratification of pediatric heart failure on the basis of neurohormonal and 
      cardiac autonomic nervous activities in patients with congenital heart disease.
PG  - 2368-76
AB  - BACKGROUND: Stratification of pediatric patients with congenital heart disease 
      (CHD) has been based on their hemodynamics and/or functional capacity. Our 
      purpose was to compare cardiac autonomic nervous activity (CANA) and 
      neurohormonal activities (NHA) with postoperative status in stable CHD patients 
      with biventricular physiology. METHODS AND RESULTS: We divided 379 subjects (297 
      CHD patients, 28 dilated cardiomyopathy patient, and 54 control subjects) into 4 
      subgroups according to New York Heart Association (NYHA) class (1.3+/-0.7) and 
      measured various CANA and NHA indices. Stepwise decreases in baroreflex 
      sensitivity (BRS), heart rate variability (HRV), adrenergic imaging, and vital 
      capacity (VC) were observed in proportion to functional capacity in normal to 
      NYHA II patients (P<0.001). However, there were no differences in these indices 
      between NYHA II and III+IV groups, whereas a stepwise proportional increase in 
      NHA indices was observed in these groups (P<0.001). Natriuretic peptides 
      differentiated all NYHA classes. BRS, HRV, and VC were greater in the adult 
      patients than in the child patients (P<0.05 to 0.01), although the functional 
      class in adult patients was lower. Cardiac surgeries resulted in low BRS and VC, 
      and the VC reduction independently determined a small HRV. Even if functional 
      class and ejection fraction were comparable, CANA and brain natriuretic peptide 
      were lower in CHD patients than in dilated cardiomyopathy patients (P<0.05 to 
      0.001). CONCLUSIONS: CANA and NHA indices are useful to stratify mild and severe 
      heart failure in stable postoperative CHD patients, respectively. However, 
      careful attention should be paid to age- and surgery-related influences on these 
      indices.
FAU - Ohuchi, Hideo
AU  - Ohuchi H
AD  - Department of Pediatrics, National Cardiovascular Center, 5-7-1, Fujishiro-dai, 
      Suita, Osaka 565-8565, Japan. hohuchi@hsp.ncvc.go.jp
FAU - Takasugi, Hisashi
AU  - Takasugi H
FAU - Ohashi, Hiroyuki
AU  - Ohashi H
FAU - Okada, Yoko
AU  - Okada Y
FAU - Yamada, Osamu
AU  - Yamada O
FAU - Ono, Yasuo
AU  - Ono Y
FAU - Yagihara, Toshikatsu
AU  - Yagihara T
FAU - Echigo, Shigeyuki
AU  - Echigo S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20031103
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
RN  - EC 3.4.23.15 (Renin)
RN  - YKH834O4BH (Epinephrine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Atrial Natriuretic Factor/blood
MH  - Baroreflex/physiology
MH  - Cardiomyopathy, Dilated/blood/etiology/physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Epinephrine/blood
MH  - Forced Expiratory Volume
MH  - Heart/diagnostic imaging
MH  - Heart Defects, Congenital/*complications/surgery
MH  - Heart Failure/blood/*classification/etiology/physiopathology
MH  - Hemodynamics
MH  - Humans
MH  - Infant
MH  - Natriuretic Peptide, Brain/blood
MH  - Postoperative Complications/blood/physiopathology
MH  - Prospective Studies
MH  - Radionuclide Imaging
MH  - Reflex, Abnormal
MH  - Renin/blood
MH  - Severity of Illness Index
MH  - Vital Capacity
EDAT- 2003/11/05 05:00
MHDA- 2003/12/10 05:00
CRDT- 2003/11/05 05:00
PHST- 2003/11/05 05:00 [pubmed]
PHST- 2003/12/10 05:00 [medline]
PHST- 2003/11/05 05:00 [entrez]
AID - 01.CIR.0000101681.27911.FA [pii]
AID - 10.1161/01.CIR.0000101681.27911.FA [doi]
PST - ppublish
SO  - Circulation. 2003 Nov 11;108(19):2368-76. doi: 
      10.1161/01.CIR.0000101681.27911.FA. Epub 2003 Nov 3.