Plasma Levels of Acylated Ghrelin in Children with Pulmonary Hypertension Associated with Congenital Heart Disease

Abstract

This study aims to estimate plasma levels of acylated ghrelin in children with pulmonary hypertension (PH) associated with congenital heart disease (CHD) and to correlate the levels of acylated ghrelin with endothelin-1 (ET-1), nitric oxide (NO), and clinical hemodynamic parameters. We investigated the plasma concentration of acylated ghrelin, ET-1, NO, and the hemodynamic parameters in 20 children with CHD, 20 children with PH-CHD, and 20 normal children. Plasma-acylated ghrelin and NO levels were significantly higher in CHD group than in control subjects (P < 0.001). Moreover, plasma-acylated ghrelin, ET-1, and NO levels were significantly elevated in PH-CHD group compared with the CHD group (P < 0.05). In PH-CHD children, plasma-acylated ghrelin levels correlated positively with pulmonary artery systolic pressure (PASP; r = 0.740, P < 0.001), pulmonary artery diastolic pressure (PADP; r = 0.613, P = 0.004), right ventricular systolic pressure (RVSP; r = 0.642, P = 0.002), mean pulmonary arterial hypertension (mPAP; r = 0.685, P = 0.001), right ventricle diameter (RVD; r = 0.473, P = 0.035), pulmonary artery trunk diameter (PAD; r = 0.613, P = 0.004), NO (r = 0.463, P = 0.04), and ET-1 (r = 0.524, P = 0.018). Plasma-acylated ghrelin levels were elevated both in CHD and in PH-CHD. Increased acylated ghrelin levels correlated positively with ET-1, NO, PASP, PADP, RVSP, mPAP, RVD, and PAD. Acylated ghrelin may be a new biomarker of PH-CHD.

Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

“…Non‐CHD adults with HF reportedly have much lower ghrelin levels than those without HF . Moreover, plasma ghrelin levels are significantly high in children with CHD . Elevated ghrelin levels in these children might be related to malnutrition, growth retardation, and chronic shunt‐induced hypoxemia, wherein increased ghrelin might be a compensatory mechanism .…”

“…24,29 Moreover, plasma ghrelin levels are significantly high in children with CHD. [8][9][10][11][12][13] Elevated ghrelin levels in these children might be related to malnutrition, growth retardation, and chronic shunt-induced hypoxemia, wherein increased ghrelin might be a compensatory mechanism. [8][9][10][11][12][13] In contrast, the mechanism underlying low ghrelin levels in adult patients with Fontan circulation and those with cyanosis is likely distinct.…”

“…Reportedly, plasma ghrelin levels are significantly high in infants and children with CHD. [8][9][10][11][12][13] An elevated ghrelin level, which has a favorable effect on growth, might be a compensatory mechanism for malnutrition and growth retardation in these patients. [8][9][10][11] Moreover, promising results with several ghrelin agonists have already been reported in animal models of HF-related body wasting.…”

Circulating LncRNAs as Novel, Non-Invasive Biomarkers for Prenatal Detection of Fetal Congenital Heart Defects

“…In addition, results vary significant between testing centers due to a lack of standards for ultrasonic inspection, differences in the quality of ultrasonic diagnostic equipment, the experience of the operator, and policies and guidelines at different centers which may influence the accuracy of ultrasonic diagnosis of fetal CHD. Recently, biomarkers such as increased acylated ghrelin [5], miR-19a [6] and beta human chorionic gonadotropin (HCGβ) [7], or decreased activity of BMP4 [8] and low levels of pregnancy associated plasma protein A (PAPP-A) [7] were found to be associated with fetal CHD, although their use as biomarkers for prenatal screening of fetal CHD is not specific.…”

Ghrelin modulates intracellular signalling pathways that are critical for podocyte survival

“…Interestingly, previous and recent data reported conflicting results regarding the physiologic effect of ghrelin. Oppositely, Li et al found that plasma acylated ghrelin positively correlated with pulmonary hypertension associated with congenital heart disease 34. Recent evidence showed that both forms produced physiologic effects explaining the physiologic discrepancies in ghrelin effect.…”