Serum N-terminal atrial natriuretic peptide in adult patients late after surgical repair of atrial septal defect
Background: The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases. Aims: To examine whether patie...
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| Published in | European journal of heart failure Vol. 2; no. 2; pp. 161 - 165 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Blackwell Publishing Ltd
01.06.2000
Elsevier |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1388-9842 1879-0844 |
| DOI | 10.1016/S1388-9842(00)00076-3 |
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| Abstract | Background:
The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases.
Aims:
To examine whether patients after surgical repair of ASD have higher concentrations of N-terminal atrial natriuretic peptide (ANP-N) than age-, sex- and body mass index (BMI)-matched control subjects.
Methods:
Medical history, physical examination, standard 12-lead electrocardiogram, and ANP-N concentrations were obtained in 65 adult patients operated for ASD at the age of 21 ± 13 years (mean ± standard deviation), 21 ± 6 years after surgical closure of ASD. Sixty-seven healthy subjects matched for age, sex and BMI served as controls.
Results:
In the patients serum ANP-N was higher than in the control subjects 0.41 ± 0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21-0.49 nmol/l vs. 0.24 ± 0.12 nmol/l, median 0.23 nmol/l, IQR 0.17-0.29 nmol/l, (P = 0.0003). Patients with concomitant diseases had higher ANP-N concentrations (0.51 ± 0.39 nmol/l, median 0.34, IQR 0.26-0.73 nmol/l) than ASD patients without any history or signs of disease (0.28 ± 0.16 nmol/l, median 0.27, IQR 0.17-0.40 nmol/l, P = 0.01). The 'healthy' ASD patients had higher hormone concentrations than age-, sex- and BMI-matched control subjects (0.28 ± 0.16 median 0.27 nmol/l, IQR 0.17-0.40 nmol/l and 0.21 ± 0.07 nmol/l, median 0.20 nmol/l, IQR 0.15-0.27 nmol/l, P = 0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post-operative ANP-N concentration (r
2 = 0.25, P = 0.0002).
Conclusion:
ASD patients have higher ANP-N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence. |
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| AbstractList | The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases.
To examine whether patients after surgical repair of ASD have higher concentrations of N-terminal atrial natriuretic peptide (ANP-N) than age-, sex- and body mass index (BMI)-matched control subjects.
Medical history, physical examination, standard 12-lead electrocardiogram, and ANP-N concentrations were obtained in 65 adult patients operated for ASD at the age of 21+/-13 years (mean+/-standard deviation), 21+/-6 years after surgical closure of ASD. Sixty-seven healthy subjects matched for age, sex and BMI served as controls.
In the patients serum ANP-N was higher than in the control subjects 0.41+/-0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21-0.49 nmol/l vs. 0.24+/-0.12 nmol/l, median 0.23 nmol/l, IQR 0.17-0.29 nmol/l, (P=0.0003). Patients with concomitant diseases had higher ANP-N concentrations (0.51+/-0.39 nmol/l, median 0.34, IQR 0.26-0.73 nmol/l) than ASD patients without any history or signs of disease (0.28+/-0.16 nmol/l, median 0.27, IQR 0.17-0.40 nmol/l, P=0.01). The 'healthy' ASD patients had higher hormone concentrations than age-, sex- and BMI-matched control subjects (0.28+/-0.16 median 0.27 nmol/l, IQR 0. 17-0.40 nmol/l and 0.21+/-0.07 nmol/l, median 0.20 nmol/l, IQR 0. 15-0.27 nmol/l, P=0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post-operative ANP-N concentration (r(2)=0.25, P=0.0002).
ASD patients have higher ANP-N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence. The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases.BACKGROUNDThe purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases.To examine whether patients after surgical repair of ASD have higher concentrations of N-terminal atrial natriuretic peptide (ANP-N) than age-, sex- and body mass index (BMI)-matched control subjects.AIMSTo examine whether patients after surgical repair of ASD have higher concentrations of N-terminal atrial natriuretic peptide (ANP-N) than age-, sex- and body mass index (BMI)-matched control subjects.Medical history, physical examination, standard 12-lead electrocardiogram, and ANP-N concentrations were obtained in 65 adult patients operated for ASD at the age of 21+/-13 years (mean+/-standard deviation), 21+/-6 years after surgical closure of ASD. Sixty-seven healthy subjects matched for age, sex and BMI served as controls.METHODSMedical history, physical examination, standard 12-lead electrocardiogram, and ANP-N concentrations were obtained in 65 adult patients operated for ASD at the age of 21+/-13 years (mean+/-standard deviation), 21+/-6 years after surgical closure of ASD. Sixty-seven healthy subjects matched for age, sex and BMI served as controls.In the patients serum ANP-N was higher than in the control subjects 0.41+/-0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21-0.49 nmol/l vs. 0.24+/-0.12 nmol/l, median 0.23 nmol/l, IQR 0.17-0.29 nmol/l, (P=0.0003). Patients with concomitant diseases had higher ANP-N concentrations (0.51+/-0.39 nmol/l, median 0.34, IQR 0.26-0.73 nmol/l) than ASD patients without any history or signs of disease (0.28+/-0.16 nmol/l, median 0.27, IQR 0.17-0.40 nmol/l, P=0.01). The 'healthy' ASD patients had higher hormone concentrations than age-, sex- and BMI-matched control subjects (0.28+/-0.16 median 0.27 nmol/l, IQR 0. 17-0.40 nmol/l and 0.21+/-0.07 nmol/l, median 0.20 nmol/l, IQR 0. 15-0.27 nmol/l, P=0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post-operative ANP-N concentration (r(2)=0.25, P=0.0002).RESULTSIn the patients serum ANP-N was higher than in the control subjects 0.41+/-0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21-0.49 nmol/l vs. 0.24+/-0.12 nmol/l, median 0.23 nmol/l, IQR 0.17-0.29 nmol/l, (P=0.0003). Patients with concomitant diseases had higher ANP-N concentrations (0.51+/-0.39 nmol/l, median 0.34, IQR 0.26-0.73 nmol/l) than ASD patients without any history or signs of disease (0.28+/-0.16 nmol/l, median 0.27, IQR 0.17-0.40 nmol/l, P=0.01). The 'healthy' ASD patients had higher hormone concentrations than age-, sex- and BMI-matched control subjects (0.28+/-0.16 median 0.27 nmol/l, IQR 0. 17-0.40 nmol/l and 0.21+/-0.07 nmol/l, median 0.20 nmol/l, IQR 0. 15-0.27 nmol/l, P=0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post-operative ANP-N concentration (r(2)=0.25, P=0.0002).ASD patients have higher ANP-N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence.CONCLUSIONASD patients have higher ANP-N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence. Background: The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases. Aims: To examine whether patients after surgical repair of ASD have higher concentrations of N-terminal atrial natriuretic peptide (ANP-N) than age-, sex- and body mass index (BMI)-matched control subjects. Methods: Medical history, physical examination, standard 12-lead electrocardiogram, and ANP-N concentrations were obtained in 65 adult patients operated for ASD at the age of 21 ± 13 years (mean ± standard deviation), 21 ± 6 years after surgical closure of ASD. Sixty-seven healthy subjects matched for age, sex and BMI served as controls. Results: In the patients serum ANP-N was higher than in the control subjects 0.41 ± 0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21-0.49 nmol/l vs. 0.24 ± 0.12 nmol/l, median 0.23 nmol/l, IQR 0.17-0.29 nmol/l, (P = 0.0003). Patients with concomitant diseases had higher ANP-N concentrations (0.51 ± 0.39 nmol/l, median 0.34, IQR 0.26-0.73 nmol/l) than ASD patients without any history or signs of disease (0.28 ± 0.16 nmol/l, median 0.27, IQR 0.17-0.40 nmol/l, P = 0.01). The 'healthy' ASD patients had higher hormone concentrations than age-, sex- and BMI-matched control subjects (0.28 ± 0.16 median 0.27 nmol/l, IQR 0.17-0.40 nmol/l and 0.21 ± 0.07 nmol/l, median 0.20 nmol/l, IQR 0.15-0.27 nmol/l, P = 0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post-operative ANP-N concentration (r 2 = 0.25, P = 0.0002). Conclusion: ASD patients have higher ANP-N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence. Background: The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial peptides are released in congestive heart failure, valvular diseases and congenital heart diseases. Aims: To examine whether patients after surgical repair of ASD have higher concentrations of N‐terminal atrial natriuretic peptide (ANP‐N) than age‐, sex‐ and body mass index (BMI)‐matched control subjects. Methods: Medical history, physical examination, standard 12‐lead electrocardiogram, and ANP‐N concentrations were obtained in 65 adult patients operated for ASD at the age of 21 ± 13 years (mean ± standard deviation), 21 ± 6 years after surgical closure of ASD. Sixty‐seven healthy subjects matched for age, sex and BMI served as controls. Results: In the patients serum ANP‐N was higher than in the control subjects 0.41 ± 0.32 nmol/l, median 0.31 nmol/l, interquartile range (IQR) 0.21–0.49 nmol/l vs. 0.24 ± 0.12 nmol/l, median 0.23 nmol/l, IQR 0.17–0.29 nmol/l, (P = 0.0003). Patients with concomitant diseases had higher ANP‐N concentrations (0.51 ± 0.39 nmol/l, median 0.34, IQR 0.26–0.73 nmol/l) than ASD patients without any history or signs of disease (0.28 ± 0.16 nmol/l, median 0.27, IQR 0.17–0.40 nmol/l, P = 0.01). The ‘healthy’ ASD patients had higher hormone concentrations than age‐, sex‐ and BMI‐matched control subjects (0.28 ± 0.16 median 0.27 nmol/l, IQR 0.17–0.40 nmol/l and 0.21 ± 0.07 nmol/l, median 0.20 nmol/l, IQR 0.15–0.27 nmol/l, P = 0.01). Multiple stepwise linear regression analysis showed that age at operation was strongly associated with the post‐operative ANP‐N concentration (r2 = 0.25, P = 0.0002). Conclusion: ASD patients have higher ANP‐N concentrations late after surgical repair. Hormone levels correlate with age at operation. Our finding supports the clinical praxis of operating on these patients in their childhood and adolescence. |
| Author | Groundstroem, Kaj W.E. Uusitalo, Arto Talvensaari, Taisto J. Lahtela, Jorma T. Pasternack, Amos Iivainen, Tiina E. |
| Author_xml | – sequence: 1 givenname: Tiina E. surname: Iivainen fullname: Iivainen, Tiina E. email: kljola@uta.fi organization: Department of Clinical Physiology, Tampere University Hospital, P.O. Box 2000, FIN-33520, Tampere, Finland – sequence: 2 givenname: Kaj W.E. surname: Groundstroem fullname: Groundstroem, Kaj W.E. organization: Department of Internal Medicine, Tampere University Hospital, Tampere, Finland – sequence: 3 givenname: Jorma T. surname: Lahtela fullname: Lahtela, Jorma T. organization: Department of Internal Medicine, Tampere University Hospital, Tampere, Finland – sequence: 4 givenname: Taisto J. surname: Talvensaari fullname: Talvensaari, Taisto J. organization: Department of Internal Medicine, Tampere University Hospital, Tampere, Finland – sequence: 5 givenname: Amos surname: Pasternack fullname: Pasternack, Amos organization: Department of Internal Medicine, Tampere University Hospital, Tampere, Finland – sequence: 6 givenname: Arto surname: Uusitalo fullname: Uusitalo, Arto organization: Department of Clinical Physiology, Tampere University Hospital, P.O. Box 2000, FIN-33520, Tampere, Finland |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/10856729$$D View this record in MEDLINE/PubMed |
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| Copyright | 2000 European Society of Cardiology 2000 Published on behalf of the European Society of Cardiology. All rights reserved. © 2000 the Authors |
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| Keywords | Heart Atrial septal defect Haemodynamics Congenital heart defect Surgery Natriuretic peptide |
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| References_xml | – reference: ChenH.HBurnettJ.CThe natriuretic peptides in heart failure: diagnostic and therapeutic potentialsProc Assoc Am Phys1999111406416 – reference: HallCRouleauJ.LMoyèL et al. N-Terminal proatrial natriuretic factor. an independent predictor of long-term prognosis after myocardial infarctionCirculation19948919341942 – reference: SeldonW.ARubinsteinCFraserA.AThe incidence of atrial septal defect in adultsBr Heart J196224557560 – reference: HuysmansH.AVrakkingMvan BovenW.J.PLate follow-up after surgical correction of atrial septal defect of the secundum typeZ Kardiol19897Suppl4345 – reference: MeijboomFHessJSzatmariA et al. Long-term follow-up (9 to 20 years) after surgical closure of atrial septal defect at a young ageAm J Cardiol19937214311434 – reference: LangR.EDietzRMerkelAUngerTRuskoahoHGantenDPlasma atrial natriuretic peptide values in cardiac diseaseJ Hypertens19864Suppl 2119123 – reference: BidlingmaierJ.WDöhlemannCKuhnleUStromTLangR.EComparison of plasma atrial natriuretic peptide levels in healthy children from birth to adolescence and in children with cardiac diseasesPediatr Res19862013281331 – reference: TikkanenIHeleniusTHeinänenTSoveriPN-terminal atrial natriuretic peptide (ANP-N) in heart failure [Abstr.]Scand J Clin Lab Invest199555Suppl 223645 – reference: IivanainenA.MTikkanenITilvisRHeikkiläJHeleniusTKupariMAssociations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sampleJ Intern Med1997241261268 – reference: FyhrquistFTikkanenIAtrial natriuretic peptide in congestive heart failureAm J Cardiol19886220A24A – reference: SiltanenP. Atrial septal defect of secundum type in adults. Acta Med Scand 1968;497(Suppl):1-151. – reference: HolmströmHThaulowEStokkeOLindbergHHallCSerum N-terminal proatrial natriuretic factor in children with congenital heart diseaseEur Heart J19961717371746 – reference: The declaration of HelsinkiBr Med J1964II177 – reference: KikuchiKNishiokaKUedaT et al. Relationship between plasma atrial natriuretic polypeptide concentration and hemodynamic measurements in children with congenital heart diseasesJ Pediatr1987111335342 – reference: KindelanA.ANaveroJ.L.PDe La RosaI.IRuizM.CLopezP.MLezcanoA.RRelationship between hemodynamic changes and blood hormone concentrations after cardiac surgery in children with congenital heart diseaseCrit Care Med19942217541761 – reference: BonowR.ONew insights into the cardiac natriuretic peptidesCirculation19969319461950 – reference: UchiyamaMSatokataISakaiKPlasma atrial natriuretic peptide in congenital heart diseaseActa Paediatr198776669670 – reference: MatsuokaSKurahashiYMikiY et al. Plasma atrial natriuretic peptide in patients with congenital heart diseasesPediatrics198882639643 – reference: GuidelinesSub-Committee1993 Guidelines for the management of mild hypertension: memorandum from a World Health Organization/International Society of Hypertension meetingJ Hypertens199311905918 – reference: AgnolettiGScottiCPanzaliA.F et al. Plasma levels of atrial natriuretic factor (ANF) and urinary excretion of ANF, arginine vasopressin and catecholamines in children with congenital heart disease: effect of cardiac surgeryEur J Cardio-thorac Surg19937533539 – reference: Espino-VelaJAlvarado-ToroANatural history of atrial septal defectCardiovasc Clin19712103125 – reference: SamanekMSlavikZZborilovaBHrobonovaVVoriskovaMSkovranekJPrevalence, treatment, and outcome of heart disease in live-born children: a prospective analysis of 91,823 live-born childrenPediatr Cardiol198910205211 – reference: MurphyJ.GGershB.JMcGoonM.D et al. Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 yearsN Engl J Med199032316451650 – reference: MontorsiPTonoloGPoloniaJHepburnDRichardsMCorrelates of plasma atrial natriuretic factor in health and hypertensionHypertension198710570576 – volume: 2 start-page: 103 year: 1971 end-page: 125 article-title: Natural history of atrial septal defect publication-title: Cardiovasc Clin – volume: 323 start-page: 1645 year: 1990 end-page: 1650 article-title: Long‐term outcome after surgical repair of isolated atrial septal defect. 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Circulation – volume: 111 start-page: 406 year: 1999 end-page: 416 article-title: The natriuretic peptides in heart failure: diagnostic and therapeutic potentials publication-title: Proc Assoc Am Phys – volume: 111 start-page: 335 year: 1987 end-page: 342 article-title: Relationship between plasma atrial natriuretic polypeptide concentration and hemodynamic measurements in children with congenital heart diseases publication-title: J Pediatr – volume: 22 start-page: 1754 year: 1994 end-page: 1761 article-title: Relationship between hemodynamic changes and blood hormone concentrations after cardiac surgery in children with congenital heart disease publication-title: Crit Care Med – volume: 241 start-page: 261 year: 1997 end-page: 268 article-title: Associations between atrial natriuretic peptides, echocardiographic findings and mortality in an elderly population sample publication-title: J Intern Med – volume: 76 start-page: 669 year: 1987 end-page: 670 article-title: Plasma atrial natriuretic peptide in congenital heart disease publication-title: Acta Paediatr – volume: 93 start-page: 1946 year: 1996 end-page: 1950 article-title: New insights into the cardiac natriuretic peptides publication-title: Circulation – volume: 82 start-page: 639 year: 1988 end-page: 643 article-title: Plasma atrial natriuretic peptide in patients with congenital heart diseases publication-title: Pediatrics – volume: 62 start-page: 20A year: 1988 end-page: 24A article-title: Atrial natriuretic peptide in congestive heart failure publication-title: Am J Cardiol – volume: 10 start-page: 205 year: 1989 end-page: 211 article-title: Prevalence, treatment, and outcome of heart disease in live‐born children: a prospective analysis of 91,823 live‐born children publication-title: Pediatr Cardiol – volume: 7 start-page: 43 issue: Suppl year: 1989 end-page: 45 article-title: Late follow‐up after surgical correction of atrial septal defect of the secundum type publication-title: Z Kardiol – volume: 55 start-page: 645 issue: Suppl 223 year: 1995 article-title: N‐terminal atrial natriuretic peptide (ANP‐N) in heart failure [Abstr.] publication-title: Scand J Clin Lab Invest – volume: 20 start-page: 1328 year: 1986 end-page: 1331 article-title: Comparison of plasma atrial natriuretic peptide levels in healthy children from birth to adolescence and in children with cardiac diseases publication-title: Pediatr Res – volume: 24 start-page: 557 year: 1962 end-page: 560 article-title: The incidence of atrial septal defect in adults publication-title: Br Heart J – volume: 4 start-page: 119 issue: Suppl 2 year: 1986 end-page: 123 article-title: Plasma atrial natriuretic peptide values in cardiac disease publication-title: J Hypertens – volume: II start-page: 177 year: 1964 article-title: The declaration of Helsinki publication-title: Br Med J – volume: 11 start-page: 905 year: 1993 end-page: 918 article-title: 1993 Guidelines for the management of mild hypertension: memorandum from a World Health Organization/International Society of Hypertension meeting publication-title: J Hypertens – volume: 7 start-page: 533 year: 1993 end-page: 539 article-title: Plasma levels of atrial natriuretic factor (ANF) and urinary excretion of ANF, arginine vasopressin and catecholamines in children with congenital heart disease: effect of cardiac surgery publication-title: Eur J Cardio‐thorac Surg – volume: 4 start-page: 119 issue: 2 year: 1986 ident: e_1_2_6_15_1 article-title: Plasma atrial natriuretic peptide values in cardiac disease publication-title: J Hypertens – volume: 7 start-page: 43 year: 1989 ident: e_1_2_6_7_1 article-title: Late follow‐up after surgical correction of atrial septal defect of the secundum type publication-title: Z Kardiol – ident: e_1_2_6_16_1 doi: 10.1097/00004872-199309000-00004 – ident: e_1_2_6_25_1 doi: 10.1161/01.HYP.10.6.570 – volume: 55 start-page: 645 issue: 223 year: 1995 ident: e_1_2_6_17_1 article-title: N‐terminal atrial natriuretic peptide (ANP‐N) in heart failure [Abstr.] publication-title: Scand J Clin Lab Invest – ident: e_1_2_6_19_1 doi: 10.1016/S0002-9149(88)80080-8 – ident: e_1_2_6_2_1 doi: 10.1007/BF02083294 – ident: e_1_2_6_21_1 doi: 10.1161/01.CIR.89.5.1934 – ident: e_1_2_6_14_1 doi: 10.1093/oxfordjournals.eurheartj.a014759 – ident: e_1_2_6_20_1 doi: 10.1046/j.1365-2796.1997.113124000.x – ident: e_1_2_6_9_1 doi: 10.1111/paa.1999.111.5.406 – start-page: 177 year: 1964 ident: e_1_2_6_18_1 article-title: The declaration of Helsinki publication-title: Br Med J – volume: 2 start-page: 103 year: 1971 ident: e_1_2_6_4_1 article-title: Natural history of atrial septal defect publication-title: Cardiovasc Clin – ident: e_1_2_6_10_1 doi: 10.1161/01.CIR.93.11.1946 – ident: e_1_2_6_11_1 doi: 10.1111/j.1651-2227.1987.tb10541.x – ident: e_1_2_6_8_1 doi: 10.1016/0002-9149(93)90192-F – ident: e_1_2_6_23_1 doi: 10.1097/00003246-199411000-00009 – volume: 82 start-page: 639 year: 1988 ident: e_1_2_6_13_1 article-title: Plasma atrial natriuretic peptide in patients with congenital heart diseases publication-title: Pediatrics doi: 10.1542/peds.82.4.639 – ident: e_1_2_6_3_1 doi: 10.1136/hrt.24.5.557 – ident: e_1_2_6_5_1 doi: 10.1056/NEJM199012133232401 – ident: e_1_2_6_12_1 doi: 10.1016/S0022-3476(87)80450-X – ident: e_1_2_6_24_1 doi: 10.1016/1010-7940(93)90052-D – volume: 497 start-page: 1 year: 1968 ident: e_1_2_6_6_1 article-title: Atrial septal defect of secundum type in adults publication-title: Acta Med Scand – ident: e_1_2_6_22_1 doi: 10.1203/00006450-198612000-00029 |
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The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts... The purpose of surgical closure of atrial septal defect (ASD) is to relieve the cardiovascular system from a haemodynamic burden. Excessive amounts of atrial... |
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| SubjectTerms | Adult Aged Atrial Natriuretic Factor - blood Atrial septal defect Cardiac Surgical Procedures Congenital heart defect Female Haemodynamics Heart Heart Septal Defects, Atrial - blood Heart Septal Defects, Atrial - surgery Hemodynamics Humans Male Middle Aged Natriuretic peptide Postoperative Period Regression Analysis Surgery |
| Title | Serum N-terminal atrial natriuretic peptide in adult patients late after surgical repair of atrial septal defect |
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