Chest
Lung β-Adrenoceptors in Pulmonary Hypertension*: A Study of Biopsy Specimens in Children with Congenital Heart Disease
Section snippets
Subjects and General Diagnostic Procedures
Characterization of lung β-adrenoceptors was carried out in 11 children with pulmonary hypertension aged four months to 15 years (median, three years) who were considered candidates for surgical repair of congenital heart defects at the Heart Institute, University of Sao Paulo. In these children, small lung specimens for receptor characterization were obtained at the time of routine biopsy procedures in order to evaluate the extent of pulmonary vasoocclusive disorder. At cardiac catheterization
Hemodynamic and Histologic Findings
The mean pulmonary arterial pressure ranged from 33 to 101 mm Hg in children with pulmonary hypertension (Table 1).
In histologic examination of lung biopsy material, increased arterial muscularity was observed in all patients. The medial thickness of terminal bronchiolar, respiratory bronchiolar, and alveolar duct arteries was 21.8 ± 1.8, 22.8 ± 4.3, and 20.1 ± 4.1 percent, respectively.
Intimal lesions compatible with Heath-Edwards grade 2, 3, or 4 were observed in seven patients. The
DISCUSSION
A major limitation of the present study was the relative difficulty in obtaining lung specimens for receptor characterization from children with normal pulmonary pressures. For ethical reasons, we were only able to include in the study subjects from whom lung specimens could be obtained during routine diagnostic or therapeutic procedures.
Information concerning adrenoceptor behavior in pulmonary vaso-occlusive disorders remains limited. Most reports focusing on β-adrenoceptor alterations in lung
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Supported by Fundacão de Amparo à Pesquisa do Estado de São Paulo, grant 87/0511-9.