Ayhan PEKTAŞ, Resit KOKEN, Bugra H KOCA, Bilgehan M PEKTAŞ

The Oxidative Status of Children with Acyanotic Congenital Heart Diseases: A Randomized Controlled Study

Amaç: Bu çalışmada, soldan sağa şantlı doğumsal kalp hastalığı olan çocuklarda, total oksidan statü (TOS), total antioksidan statü (TAS) ve oksidatif stress indeksi (OSI) belirlenerek etkilenmiş çocukların oksidatif durumunun değerlendirilmesi amaçlanmaktadır. Gereç ve Yöntem: Bu ileriye dönük, randomize, vaka-kontrol çalışmasında, 40 sağlıklı çocukla soldan sağa şantlı doğumsal kalp hastalığı bulunan 40 çocuk karşılaştırılmıştır. Bulgular: Sağlıklı çocuklarla soldan sağa şantlı doğumsal kalp hastalığı bulunan çocuklar; istatistiksel olarak benzer yaşa, cinsiyete, vücut ağırlığına, boya ve vücut kitle indeksine sahiptir (hepsi için p>0.05). Bu iki grup, interventriküler septum kalınlığı, sol ventrikül iç çapı, sol ventrikül posterior duvar kalınlığı, sistolik hacim, diastol sonu hacim, fraksiyonel kısalma, ejeksiyon fraksiyonu ve sol ventrikül kitle değerleri gibi ekokardiyografi bulguları bakımından istatistiksel olarak benzerdir (her biri için p>0.05). Ayrıca, iki grup da, sol ventrikül, interventriküler septum ve sağ ventrikül için myokardial performans indeksi, E´, A´, S´, gevşeme zamanı ve kontraksiyon zamanı değerleri açısından istatistiksel olarak benzerdir (hepsi için p>0.05). sağlıklı çocuklarla soldan sağa şantlı doğumsal kalp hastalığı bulunan çocuklar; istatistiksel olarak benzer kan sayımı parametrelerine, serum D vitamini ve beyin natriüretik peptit konsantrasyonlarına sahiptir. Sağlıklı çocuklarla karşılaştırıldığında, soldan sağa şantlı doğumsal kalp hastalığı bulunan çocuklara ait TOS ve OSI değerleri anlamlı olarak yüksektir (sırasıyla, TOS için, 35.6±2.8 nmol H2O2 equiv/mg protein vs 16.1±4.6 nmol H2O2 equiv/mg protein, p=0.018 ve OSI için 32.4±1.4 vs 11.5±3.2, p=0.022). Sonuç: Prooksidan ve antioksidan reaksiyonların arasındaki dengesizlik, oksidatif stres artışına yol açar ve bu artış, soldan sağa şantlı doğumsal kalp hastalıklarının patogenezine katkıda bulunabilir.

Asiyanotik Doğumsal Kalp Hastalığı olan Çocuklarda Oksidatif Durum: Randomize Kontrollü bir Çalışma

Objective: This study aims to investigate the role of oxidative stress congenital heart defects with left-to-right shunt by determining total oxidant status (TOS), total antioxidant status and oxidative stress index (OSI) in affected children. Methods: This is a prospective, randomized case-control study which reviews 40 healthy children and 40 children who have congenital heart defects with left-to-right shunt. Results: The healthy children and the children who have congenital heart defects with left-to-right shunt are statistically similar with respect to age, sex, height, weight and body mass index (p>0.05 for all). Both groups have statistically similar echocardiography findings including interventricular septum thickness, left ventricular internal diameter, left ventricular posterior wall, systolic volume, end diastolic volume, fractional shortening, ejection fraction and left ventricular mass values (p>0.05 for each). These groups are also statistically similar in aspect of myocardial performance index, E´, A´, S´, relaxation time and contraction time values that have been specified for left ventricle, interventricular septum and right ventricle (p>0.05 for each). The healthy children and the children with congenital heart defects have statistically similar blood count parameters as well as serum concentrations of vitamin D and brain natriuretic peptide. The children who have congenital heart defects with left-to-right shunt have significantly higher TOS and OSI values than those of the healthy children (respectively, 35.6±2.8 nmol H2O2 equiv/mg protein vs 16.1±4.6 nmol H2O2 equiv/mg protein, p=0.018 and 32.4±1.4 vs 11.5±3.2, p=0.022). Conclusion: The imbalance between the prooxidant and antioxidant reactions causes an enhancement in oxidative stress which may contribute to the pathogenesis of congenital heart defects with left-to-right shunting.

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