| Objective: to detect the relationship of calcitonin gene-related peptide (CGRP)and congenital heart diseases(CHD)with left-to-right shunt by measuring plasma CGRP before and after intervention, and its regulating effect on the CHD with pulmonary hypertension.Methods:There were 53 patients (25 males and 28 females) who under- went interventional occlusion successfully were enrolled,including 26 atrial septal defects(ASD), 7 ventricular septal defects (VSD) and 20 patent ductus arteriosus (PDA). The patients'age were from 12 to 53(36±16.5)years and their body weight were between 25 and 65 (43.5±12.5)kg. None of them had diseases such as hypertension, heart failure, or pulmonary, renal, cerebral and hematological disease. During right heart catheterization, the pressure at several arranged sites in cardiac cavities and pulmonary artery were measured and blood samples were abstracted to calculate shunt flow.1) Patients were divided into three groups according to pulmonary artery pressure:16 patients in the normal group (systolic pressure<30mmH- g),20 patients in the mild pulmonary hypertension group (systolic pressure≥30-50mmHg),17 patients in moderate to severe pulmonary hypertension group(systolic pressure≥50mmHg in 10 patients and≥90mmHg in 7 patients). There were no statistical significance among the three groups in age and sex (P>0.05). the control group was consisted of 16 healthy persons (8 males and 8 females), age from 13 to 52(35±14.8)years. 2) Plasma CGRP were measured before intervention and one hour, 24hours ,30 days after interve-ntion.3)2ml peripheral venous blood sample were abstracted and then injected into tubes containing 10% EDTA-Na2 disodium 30 microliter and aprotinin 40 microliter. Plasma were keptin -70oC refrigerator after centrifugation,and agent kits were freely supplied by the radio- immuno- logical institute of the scientific development center in General Hospital of People's Liberation Army.4) Statistical analysis: SPSS11.5 software package. All datas are expressed as mean±standard deviation ( x±s). Difference among groups were analyzed by ANOVA(analysis of varience). Mean value in the same group were compared by t-test , while in different group by q-test and Pearson's correlation. P<0.05 was considered statistically significant.Results:1) there was no significant difference in plasma CGRP level between the control group and normal pulmonary artery pressure group before operation(P>0.05),and that of the mild pulmonary hypertension group was lower than the control group (P<0.01), moreover, that of the moderate to severe pulmonary hypertension group was obviously lower than the control(P<0.001).2)1 hour,24 hours and 30days after intervention, the plasma CGRP level in the mild and moderate to serve pulmonary hyper- tension groups has increased than before (P<0.01) , and it in the normal group has not changed(P>0.05). In the following 30 days ,the CGRP level in the nomal group and mild pulmonary hypertension has not changed than the same that in the following 24 hours(P>0.05) ,but the CGRP level in the moderate to serve pulmonary hypertension groups still tends to increase (P<0.01).3)The CGRP level has related negatively with the pulmonary arterial systolic pressure of the CHD paithents (r=-0. 677,P<0.01),and has related negatively with the shunted volume/the pulmonary circulantion volume (r=-0.394,P=0.004<0.01).Conclusion:1.CGRP which is a strong vascular relaxing neuron-multipeptide correlates closely with the change of CHD'pulmonary pressure. It maybe as a reference target to evaluate the pulmonary hypertension.2.The level of CGRP relates closely the left-to-right shunted volume.3.To the CHD patients who have mild and serve pulmonary hyper- tension , the CGRP level in blood plasma recovering to the normal level still needs a long periord after intervension .
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