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. |
