Abstract
Plasma levels of atrial natriuretic peptide (ANP) and haemodynamic indices were measured in 9 patients with patent ductus arteriosus (PDA) before and after ligation of ductus. The patients were 8 children and 1 adult. Before operation, ANP levels were 157.8±118.6 (mean±SD) pg/ml. After induction of anesthesia, ANP levels were significantly increased compared to pre-operative levels. Three days after the operation, there was a significant decrease in ANP levels to 56.3±39.2 pg/ml. There was no significant correlation between ANP levels and either blood pressure or heart rate throughout this study. In four cases, central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) during operation were using Swan-Ganz catheter. After ligation of the ductus, PCWP fell significantly, whereas there were no remarakable changes in CVP. ANP levels decreased immediately after restoring PCWP by ligation of the ductus, and there was close correlation between ANP level and PCWP throughout the operative stages. The plasma levels of ANP in patients with PDA were correlated with Qp/Qs (pulmonary to systemic blood flow) ratio, Pp/Ps (systolic pulmonary arterial pressure to systolic systemic arterial pressure) ratio, mean pulmonary arterial pressure, and RVSTI (right ventricular systolic time intervals) measured by echocardiography. Thus it is strongly suggested that the measurment of ANP levels in patient with PDA may be valuable in evaluating of clinical severity.
