STUDY OF ATRIAL NATRIURETIC PEPTIDE IN PATIENTS WITH BRONCHIAL ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASES
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The present study was carried out to study the changes in plasma atrial natriuretic peptide (ANP) in asthmatic children and in cases with chronic obstructive pulmonary disease (COPD) and to correlate these changes with the ventilatory and cardiac functions in the COPD group. About 105 subjects were selected from Pediatric and Chest Departments, Benha University Hospital. They were classified into 20 asthmatic children (Group A1 ), who were reinvestigated 4 weeks after treatment (Group A2). Their age ranged from 1.5 to 11 years old. This group of patients was compared with 15 healthy children matched for the same ages and sex. Another 60 patients with COPD were subclassified into 3 subgroups. Subgroup 1: included 20 cases on hospital admission with acute infective exacerbation (subgroup Ia), those cases were reinvestigated 6 weeks after medical treatment (subgroup Ib). Subgroup II : included 20 patients with COPD cor-pulmonale and right-sided heart failure. Subgroup III: included 20 patients with COPD without corpulmonale. Their age ranged from 40 to 74 years old. This group of patients were compared with 10 healthy subjects matched for the same ages and sex. For all groups, plasma ANP was done while ventilatory functions and echocardiography was done for COPD group only. The main results of this study, showed that plasma ANP was significantly elevated in asthmatic children compared with the control group but, it was significantly higher in subgroups A1 in comparison to subgroup A2. In the COPD group, ANP was significantly elevated in all subgroups. The highest level in subgroup Ia, the lowest level was in subgroup III. ANP was significantly elevated in subgroup II in comparison to lb and III subgroups. Also, ANP was correlated with mean pulmonary artery pressure (PAP), surface area of right atrium (RAsa), right atrial diameter (RAD), right ventricular diameter (RVD) and right ventricular anterior wall (RVAW) diameter. The decrease of ANP in subgroup lb was associated with improvement in the ventilatory and cardiac functions. We could conclude that; ANP was elevated and correlated with the severity of the disease in both asthmatic and COPD cases. Also, it was correlated with the degree of PAP, right atrial and right ventricular dimensions. So, ANP may give a new meaning in the future for the treatment of both asthmatic and COPD cases.