OBJECTIVETo assess the perioperative changes in plasma endothelin (ET) and calcitonin gene-related peptide (CGRP) in children with congenital heart disease complicated by pulmonary hypertension.

METHODSIn 33 patients, radioimmunoassay was used to measure plasma ET and CGRP levels at different time points: Preoperative, immediate post-op, 3 hrs, 24 hrs, 72 hrs after cardiac surgery with cardiopulmonary bypass.

RESULTSPreoperative plasma ET levels in two groups were markedly increased. The level of ET in group II (severe pulmonary hypertension patients) was significantly higher than those [(138+/-25 compared with 77+/-19)pg/ml, P<0.01] in group I (mild pulmonary hypertension patients). In group I, the plasma ET level rose immediately post-op (P<0.001) and retumed to the initial level after one day (P>0.05). However, in group II plasma ET level was only normalized 3 days post-op (P<0.05). The CGRP level of both group I and group II increased at the first post-op day [(187+/-131 330+/-187)pg/ml], then began to decline by the 3rd day [(88+/-85, 150+/-95) pg/ml].

CONCLUSIONEndothelin and calcitonin gene-related peptide was involved in the pathophysiologic process of pulmonary hypertension and correlated with the degree of pulmonary hypertension. The imbalance of ET and CGRP after cardiopulmonary bypass may affect the prognosis.