A-type and B-type natriuretic peptides in cardiac surgical procedures. Export

@article{citeulike:624755, abstract = {This study was performed to determine the secretion pattern and prognostic value of A-type (ANP) and B-type (BNP) natriuretic peptide in patients undergoing cardiac surgical procedures. We measured ANP and BNP in patients undergoing coronary artery bypass grafting (CABG) with (n = 28) or without (n = 32) ventricular dysfunction and in patients undergoing mitral (n = 21) or aortic (n = 24) valve replacement, respectively. Postoperative mortality was recorded up to 730 days after operation. ANP, but not BNP, concentrations were closely associated with volume reloading of the heart after aortic cross-clamp in all patients. The secretion pattern of BNP during surgery was much less uniform. BNP, but not ANP, concentrations correlated with aortic cross-clamp time (r(2) = 0.32; P = 0.006) and postoperative troponin I concentrations (r(2) = 0.22; P = 0.0009) in bypass patients, and preoperative BNP increases were associated with a more frequent postoperative (2-yr) mortality in these patients. Markedly increased preoperative BNP concentrations in mitral (3-fold) and aortic (14-fold) valve disease patients did not further increase during cardiopulmonary surgery. The data suggest that ANP is primarily influenced by intravascular volume reloading of the heart after cross-clamp, whereas the secretion of BNP is related to other factors, such as duration of ischemia and long-term left ventricular pressure and/or excessive intravascular volume. BNP, but not ANP, was shown to be a mortality risk predictor in patients undergoing CABG. IMPLICATIONS: A-type natriuretic peptide is primarily influenced by volume reloading of the heart after cross-clamp, whereas the secretion of B-type natriuretic peptide (BNP) is related to the duration of ischemia and long-term left ventricular pressure and/or volume overload. Preoperative BNP, but not postoperative BNP, concentrations predict long-term outcome after coronary artery bypass grafting.}, address = {Klinik und Poliklinik f\"{u}r An\"{a}sthesiologie und Operative Intensivmedizin, University of M\"{u}nster, Albert-Schweitzer-Strasse 33, 48149 M\"{u}nster, Germany. berenel@uni-muenster.de}, author = {Berendes, E. and Schmidt, C. and Van Aken, H. and Hartlage, M. G. and Rothenburger, M. and Wirtz, S. and Scheld, H. H. and Brodner, G. and Walter, M.}, citeulike-article-id = {624755}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/14693575}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=14693575}, issn = {0003-2999}, journal = {Anesth Analg}, keywords = {bnp, cardiacsurgery, protocolo-bnp}, month = {January}, number = {1}, posted-at = {2006-05-12 04:14:53}, priority = {0}, title = {A-type and B-type natriuretic peptides in cardiac surgical procedures.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/14693575}, volume = {98}, year = {2004} }

TY - JOUR ID - citeulike:624755 L3 - citeulike-article-id:624755 N2 - This study was performed to determine the secretion pattern and prognostic value of A-type (ANP) and B-type (BNP) natriuretic peptide in patients undergoing cardiac surgical procedures. We measured ANP and BNP in patients undergoing coronary artery bypass grafting (CABG) with (n = 28) or without (n = 32) ventricular dysfunction and in patients undergoing mitral (n = 21) or aortic (n = 24) valve replacement, respectively. Postoperative mortality was recorded up to 730 days after operation. ANP, but not BNP, concentrations were closely associated with volume reloading of the heart after aortic cross-clamp in all patients. The secretion pattern of BNP during surgery was much less uniform. BNP, but not ANP, concentrations correlated with aortic cross-clamp time (r(2) = 0.32; P = 0.006) and postoperative troponin I concentrations (r(2) = 0.22; P = 0.0009) in bypass patients, and preoperative BNP increases were associated with a more frequent postoperative (2-yr) mortality in these patients. Markedly increased preoperative BNP concentrations in mitral (3-fold) and aortic (14-fold) valve disease patients did not further increase during cardiopulmonary surgery. The data suggest that ANP is primarily influenced by intravascular volume reloading of the heart after cross-clamp, whereas the secretion of BNP is related to other factors, such as duration of ischemia and long-term left ventricular pressure and/or excessive intravascular volume. BNP, but not ANP, was shown to be a mortality risk predictor in patients undergoing CABG. IMPLICATIONS: A-type natriuretic peptide is primarily influenced by volume reloading of the heart after cross-clamp, whereas the secretion of B-type natriuretic peptide (BNP) is related to the duration of ischemia and long-term left ventricular pressure and/or volume overload. Preoperative BNP, but not postoperative BNP, concentrations predict long-term outcome after coronary artery bypass grafting. IS - 1 JF - Anesth Analg SN - 0003-2999 AD - Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, University of Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany. berenel@uni-muenster.de TI - A-type and B-type natriuretic peptides in cardiac surgical procedures. VL - 98 KW - bnp KW - cardiacsurgery KW - protocolo-bnp AU - Berendes, E AU - Schmidt, C AU - Van Aken, H AU - Hartlage, MG AU - Rothenburger, M AU - Wirtz, S AU - Scheld, HH AU - Brodner, G AU - Walter, M PY - 2004/01// UR - http://view.ncbi.nlm.nih.gov/pubmed/14693575 ER -