NEUTROPHIL ACTIVATION AND MORBIDITY IN YOUNG-ADULTS WITH CYANOTIC CONGENITAL HEART-DISEASE

Young adults with cyanotic congenital heart disease have a high incide nce of respiratory and haemostatic problems. Activated neutrophils rel ease vasoactive and chemotactic factors which result in endothelial in jury, lung parenchymal damage and the activation of platelets and coag ulation pathways. To investigate the contribution of neutrophil activa tion to morbidity in young adults with cyanotic congenital heart disea se, plasma neutrophil elastase levels were measured in 25 cyanotic pat ients and the results compared to patients with acyanotic heart diseas e and normal controls. Neutrophil elastase levels were significantly e levated in the group with cyanotic congenital heart disease (P < 0.001 ). Platelet activation was significantly increased in the patients wit h cyanotic heart disease (P < 0.001). Platelet aggregation was impaire d only in those with haematocrits greater than 0.50 (P < 0.02). Whole blood coagulation, as determined by thrombelastography, was within nor mal limits. The reason for neutrophil activation in patients with cyan otic congenital heart disease is unclear, but activated neutrophils ma y contribute to the respiratory and haemostatic problems common to the se patients.