Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience.
Pulmonary hypertension (PH) is a major cause of morbi-mortality among patients with congenital heart disease (CHD) and also a potentially severe complication after surgical repair. Oral citrulline, a precursor to NO synthesis, is safe and efficacious for decreasing the risk of postoperative PH. Obje...
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| Formato: | Artículo revista |
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Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/27936 |
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I10-R10-article-27936 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-10 |
| container_title_str |
Revistas de la UNC |
| language |
Inglés |
| format |
Artículo revista |
| topic |
citrulline pulmonary hypertension nitric oxide cardiology citrulina hipertensión pulmonar óxido nítrico cardiología citrulina hipertensão pulmonar óxido nítrico cardiologia |
| spellingShingle |
citrulline pulmonary hypertension nitric oxide cardiology citrulina hipertensión pulmonar óxido nítrico cardiología citrulina hipertensão pulmonar óxido nítrico cardiologia Silvera Ruiz, Silene Grosso, Carola L Tablada, Margot Cabrera, Marcelo Dodelson de Kremer, Raquel Juaneda, Ernesto Laróvere, Laura E Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. |
| topic_facet |
citrulline pulmonary hypertension nitric oxide cardiology citrulina hipertensión pulmonar óxido nítrico cardiología citrulina hipertensão pulmonar óxido nítrico cardiologia |
| author |
Silvera Ruiz, Silene Grosso, Carola L Tablada, Margot Cabrera, Marcelo Dodelson de Kremer, Raquel Juaneda, Ernesto Laróvere, Laura E |
| author_facet |
Silvera Ruiz, Silene Grosso, Carola L Tablada, Margot Cabrera, Marcelo Dodelson de Kremer, Raquel Juaneda, Ernesto Laróvere, Laura E |
| author_sort |
Silvera Ruiz, Silene |
| title |
Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. |
| title_short |
Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. |
| title_full |
Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. |
| title_fullStr |
Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. |
| title_full_unstemmed |
Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. |
| title_sort |
efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. a local experience. |
| description |
Pulmonary hypertension (PH) is a major cause of morbi-mortality among patients with congenital heart disease (CHD) and also a potentially severe complication after surgical repair. Oral citrulline, a precursor to NO synthesis, is safe and efficacious for decreasing the risk of postoperative PH.
Objective: The aim of the present study was to investigate in pediatric patients the changes of plasma citrulline, arginine, homocysteine and nitric oxide (NO) metabolites and pulmonary artery pressures (PAP) pre-post cardiac surgery in order to describe our population status with regard to the risk of pulmonary hypertension and look for potential biomarkers for early detection and treatment.
Main results/Discussion: 16 Argentine pediatric patients with CHD undergoing cardiopulmonary bypass were randomized in two groups: (A) with and (B) without perioperative citrulline supplementation. We found that plasma citrulline median levels before surgery were lower in both groups respect to referential values, probably due to the poor nutritional status of our patients; only group A surpassed post-surgery the minimum recommended level to avoid PH. Furthermore, none of the patients in group A showed mean PAP higher than 20 mmHg, whereas in group B, 67% of the measurements were ≥ than the reference level.
Conclusions: We reaffirm that citrulline supplementation it is effective in reducing postoperative pulmonary hypertension and biomarkers could evidence patient status as a translational medicine application. |
| publisher |
Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/27936 |
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2022-08-20T01:27:22Z |
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I10-R10-article-279362021-07-15T20:12:32Z Efficacy of citrulline supplementation to decrease the risk of pulmonary hypertension after congenital heart disease surgery. A local experience. Eficacia del suplemento de citrulina para disminuir el riesgo de hipertensión pulmonar post-cirugía de cardiopatía congénita. Una experiencia local. Eficácia da suplementação de citrulina para diminuir o risco de hipertensão pulmonar após cirurgia de cardiopatia congênita. Uma experiência local. Silvera Ruiz, Silene Grosso, Carola L Tablada, Margot Cabrera, Marcelo Dodelson de Kremer, Raquel Juaneda, Ernesto Laróvere, Laura E citrulline pulmonary hypertension nitric oxide cardiology citrulina hipertensión pulmonar óxido nítrico cardiología citrulina hipertensão pulmonar óxido nítrico cardiologia Pulmonary hypertension (PH) is a major cause of morbi-mortality among patients with congenital heart disease (CHD) and also a potentially severe complication after surgical repair. Oral citrulline, a precursor to NO synthesis, is safe and efficacious for decreasing the risk of postoperative PH. Objective: The aim of the present study was to investigate in pediatric patients the changes of plasma citrulline, arginine, homocysteine and nitric oxide (NO) metabolites and pulmonary artery pressures (PAP) pre-post cardiac surgery in order to describe our population status with regard to the risk of pulmonary hypertension and look for potential biomarkers for early detection and treatment. Main results/Discussion: 16 Argentine pediatric patients with CHD undergoing cardiopulmonary bypass were randomized in two groups: (A) with and (B) without perioperative citrulline supplementation. We found that plasma citrulline median levels before surgery were lower in both groups respect to referential values, probably due to the poor nutritional status of our patients; only group A surpassed post-surgery the minimum recommended level to avoid PH. Furthermore, none of the patients in group A showed mean PAP higher than 20 mmHg, whereas in group B, 67% of the measurements were ≥ than the reference level. Conclusions: We reaffirm that citrulline supplementation it is effective in reducing postoperative pulmonary hypertension and biomarkers could evidence patient status as a translational medicine application. La hipertensión pulmonar (HP) es una causa importante de morbimortalidad entre pacientes con cardiopatía congénita (CHD) y también una complicación potencialmente grave después de la reparación quirúrgica. La citrulina oral, precursora de la síntesis de óxido nítrico, es segura y eficaz para disminuir el riesgo postoperatorio de HP. Objetivo: El objetivo del presente estudio fue investigar en pacientes pediátricos los cambios plasmáticos de los metabolitos citrulina, arginina, homocisteína y óxido nítrico y la presión arterial pulmonar (PAP) antes y después de la cirugía cardíaca para describir el estado de nuestra población con respecto al riesgo de HP y buscar posibles biomarcadores para su detección y tratamiento temprano. Resultados principales / Discusión: 16 pacientes pediátricos argentinos con CHD sometidos a bypass cardiopulmonar fueron aleatorizados en dos grupos: (A) con y (B) sin suplementación perioperatoria de citrulina. Encontramos que los niveles medios de citrulina en plasma antes de la cirugía fueron más bajos en ambos grupos con respecto a los valores referenciales, probablemente debido a un estado nutricional deficiente de nuestros pacientes; solo el grupo A superó el nivel mínimo recomendado para evitar la HP. Además, ninguno de los pacientes en el grupo A mostró una PAP media superior a 20mmHg, mientras que en el grupo B, el 67% de las mediciones fue mayor que el nivel de referencia. Conclusiones: Reafirmamos que la suplementación con citrulina es efectiva para reducir la HP postoperatoria y que los biomarcadores podrían evidenciar el estado del paciente como una aplicación de medicina traslacional. A hipertensão pulmonar (HP) é uma das principais causas de morbimortalidade entre pacientes com cardiopatia congênita (DCC) e também uma complicação potencialmente grave após o reparo cirúrgico. A citrulina oral, precursora da síntese do NO, é segura e eficaz para diminuir o risco de HP pós-operatória. Objetivo: O objetivo do presente estudo foi investigar em pacientes pediátricos as alterações dos metabólitos plasmáticos da citrulina, arginina, homocisteína e óxido nítrico (NO) e pressões da artéria pulmonar (PAP) pré-pós-cirurgia cardíaca, a fim de descrever nosso status populacional com com relação ao risco de hipertensão pulmonar e procure potenciais biomarcadores para detecção e tratamento precoces. Principais resultados / Discussão: 16 pacientes pediátricos argentinos com DCC submetidos à circulação extracorpórea foram randomizados em dois grupos: (A) com e (B) sem suplementação peri-operatória de citrulina. Descobrimos que os níveis médios de citrulina plasmática antes da cirurgia eram menores nos dois grupos em relação aos valores referenciais, provavelmente devido ao mau estado nutricional de nossos pacientes; somente o grupo A superou no pós-operatório o nível mínimo recomendado para evitar HP. Além disso, nenhum dos pacientes do grupo A apresentou PAP média superior a 20 mmHg, enquanto no grupo B, 67% das medidas foram ≥ acima do nível de referência. Conclusões: Reafirmamos que a suplementação com citrulina é eficaz na redução da hipertensão pulmonar no pós-operatório e os biomarcadores podem evidenciar o status do paciente como aplicação de medicamento translacional. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-12-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/27936 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 4 (2020); 249-253 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 4 (2020); 249-253 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 4 (2020); 249-253 1853-0605 0014-6722 10.31053/1853.0605.v77.n4 eng https://revistas.unc.edu.ar/index.php/med/article/view/27936/31762 https://revistas.unc.edu.ar/index.php/med/article/view/27936/31763 Derechos de autor 2020 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |