THE ROLE OF HYPOXIA IN RESPIRATORY MORBIDITY IN CONGENITAL CYANOTIC HEART DISEASE WITH OR WITHOUT INTERVENTION

Abstract

Cyanotic congenital heart disease is a multisystem disorder that affects almost all the body systems (Perloff et al, 1998). In our study, we explored the effect of cyanotic CHD on neutrophil activation, through measurement . of plasma neutrophil elastase(NE). Neutrophil activation and neutrophil elastase in particular have been implicated in a numberof disorders, with a special predilection for pulmonary damage. Fifty-seven patients with CHD and 16 apparently healthy age and sex matched controls were included in this study. The CHD patients were divided into two groups according to the presence or absence of cyanosis. All patients and controls were subjected to a full history taking and clinical examination. Laboratory investigation were done in the form of complete blood picture, CRP assay, pulse oximetric measurement of oxygen saturation, and plasma neutrophil elastase level. Full cardiological assessment was done for all, and included a plain chest X-ray, 12 lead ECG and thorough 2D and Color Doppler echocardiographic study. A subgroup of the cyanotic CHD group underwent palliation, either in the form of balloon atrial septostomy or surgical palliative shunt. Following palliation, this subgroup was reevaluated using the same investigations mentioned previously. A large percentage of the patients with CHD demonstrated malnutrition. This was more prominent in the cyanotic group.