Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation
BackgroundNO bioavailability has not been systematically examined in congenital heart disease (CHD). To assess NO in patients with CHD, we measured nasal NO (nNO) generated by the nasal epithelia, given blood NO is difficult to measure (half‐life, <2 ms). Given NO's role in hemodynamic regul...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.007447 |
| _version_ | 1811332252435480576 |
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| author | Phillip S. Adams Maliha Zahid Omar Khalifa Brian Feingold Cecilia W. Lo |
| author_facet | Phillip S. Adams Maliha Zahid Omar Khalifa Brian Feingold Cecilia W. Lo |
| author_sort | Phillip S. Adams |
| collection | DOAJ |
| description | BackgroundNO bioavailability has not been systematically examined in congenital heart disease (CHD). To assess NO in patients with CHD, we measured nasal NO (nNO) generated by the nasal epithelia, given blood NO is difficult to measure (half‐life, <2 ms). Given NO's role in hemodynamic regulation and the association of NO bioavailability with heart failure risk, we hypothesized NO levels may differ with varying severity of CHD physiologic characteristics. Methods and ResultsSix‐hundred eighteen subjects, 483 with CHD and 135 controls, had nNO measured noninvasively via the nares using American Thoracic Society/European Respiratory Society guidelines. Subjects were dichotomized as having low or normal nNO based on age‐specific cutoff values. Prevalence of low nNO was examined by various CHD physiologic feature types. Low nNO was more prevalent with CHD than controls (odds ratio, 2.28; P=0.001). A logistic regression model showed overall significance (P=0.035) for single ventricle, systemic right ventricle, ventricular dysfunction, oxygen desaturation, and heterotaxy predicting low nNO, with systemic right ventricle independently having twice the odds of low nNO (odds ratio, 2.04; P=0.014). Patients with low nNO had a higher risk of experiencing heart transplant or death (hazard ratio, 2.75; P=0.048), and heart transplant recipients (N=16) exhibited 5 times the odds of low nNO (69% versus 30%; odds ratio, 5.1; P=0.001). ConclusionsPatients with CHD have increased prevalence of low nNO, with highest odds seen with systemic right ventricle and heart transplant. Further studies are needed to investigate heart failure risks in patients with CHD with left versus right systemic ventricle physiologic characteristics and utility of low nNO for predicting heart failure risk. |
| first_indexed | 2024-04-13T16:33:55Z |
| format | Article |
| id | doaj.art-26e9b0cbd6954df689164c768dc4d712 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:33:55Z |
| publishDate | 2017-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-26e9b0cbd6954df689164c768dc4d7122022-12-22T02:39:29ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-12-0161210.1161/JAHA.117.007447Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac TransplantationPhillip S. Adams0Maliha Zahid1Omar Khalifa2Brian Feingold3Cecilia W. Lo4Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PADepartment of Developmental Biology, University of Pittsburgh School of Medicine, Pittsburgh, PADepartment of Developmental Biology, University of Pittsburgh School of Medicine, Pittsburgh, PADivision of Pediatric Cardiology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PADepartment of Developmental Biology, University of Pittsburgh School of Medicine, Pittsburgh, PABackgroundNO bioavailability has not been systematically examined in congenital heart disease (CHD). To assess NO in patients with CHD, we measured nasal NO (nNO) generated by the nasal epithelia, given blood NO is difficult to measure (half‐life, <2 ms). Given NO's role in hemodynamic regulation and the association of NO bioavailability with heart failure risk, we hypothesized NO levels may differ with varying severity of CHD physiologic characteristics. Methods and ResultsSix‐hundred eighteen subjects, 483 with CHD and 135 controls, had nNO measured noninvasively via the nares using American Thoracic Society/European Respiratory Society guidelines. Subjects were dichotomized as having low or normal nNO based on age‐specific cutoff values. Prevalence of low nNO was examined by various CHD physiologic feature types. Low nNO was more prevalent with CHD than controls (odds ratio, 2.28; P=0.001). A logistic regression model showed overall significance (P=0.035) for single ventricle, systemic right ventricle, ventricular dysfunction, oxygen desaturation, and heterotaxy predicting low nNO, with systemic right ventricle independently having twice the odds of low nNO (odds ratio, 2.04; P=0.014). Patients with low nNO had a higher risk of experiencing heart transplant or death (hazard ratio, 2.75; P=0.048), and heart transplant recipients (N=16) exhibited 5 times the odds of low nNO (69% versus 30%; odds ratio, 5.1; P=0.001). ConclusionsPatients with CHD have increased prevalence of low nNO, with highest odds seen with systemic right ventricle and heart transplant. Further studies are needed to investigate heart failure risks in patients with CHD with left versus right systemic ventricle physiologic characteristics and utility of low nNO for predicting heart failure risk.https://www.ahajournals.org/doi/10.1161/JAHA.117.007447congenital heart diseasenasal NONOright ventriclesingle ventricletransplant |
| spellingShingle | Phillip S. Adams Maliha Zahid Omar Khalifa Brian Feingold Cecilia W. Lo Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease congenital heart disease nasal NO NO right ventricle single ventricle transplant |
| title | Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation |
| title_full | Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation |
| title_fullStr | Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation |
| title_full_unstemmed | Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation |
| title_short | Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation |
| title_sort | low nasal no in congenital heart disease with systemic right ventricle and postcardiac transplantation |
| topic | congenital heart disease nasal NO NO right ventricle single ventricle transplant |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.007447 |
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