Correlation to NT-ProBNP and Remodeling after Cardiac Surgery

Boer, Berta Paula Napchan; Vieira, Marcelo Luiz Campos; Sampaio, Roney Orismar; Abensur, Henry; Oliveira, Alessandra Gomes de; Fernandes, João Ricardo Cordeiro; Grinberg, Max

doi:10.5935/abc.20130076

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…The relationship between NT-proBNP and diastolic function has been extensively studied [18][19][20][21][22]. In line with prior findings, we also identified an association between diastolic function and NT-proBNP.…”

Section: Plos Onesupporting

confidence: 90%

Evaluation of left ventricular diastolic function in patients operated for aortic stenosis

et al. 2022

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Background Left ventricular diastolic dysfunction is common in patients with aortic valve stenosis (AS) and reportedly affects prognosis after surgical aortic valve replacement (SAVR). Here we investigated whether and how diastolic function (assessed following the most recent guidelines) was affected by SAVR, and whether preoperative diastolic function affected postoperative outcome. We also examined whether long-term mortality was associated with preoperative NT-proBNP and postoperative heart failure (PHF). Methods We performed a prospective observational study of 273 patients with AS who underwent AVR with or without concomitant coronary artery bypass surgery. Of these patients, 247 were eligible for assessment of left ventricular (LV) filling pressure. Preoperatively and at the 6-month postoperative follow-up, we measured N-terminal pro-B type natriuretic peptide (NT-proBNP) in serum and assessed diastolic function with Doppler echocardiography. PHF was diagnosed using prespecified criteria. Multivariable logistic regression was performed to explore variables associated with high LV filling pressure. Cox regression was performed to explore variables associated with mortality, accounting for timeto-event. Results At the time of surgery, 22% (n = 54) of patients had diastolic dysfunction expressed as high LV filling pressure. Of these 54 patients, 27 (50%) showed postoperative diastolic function improvement. Among the 193 patients with preoperative low LV filling pressure, 24 (12%) showed postoperative diastolic function deterioration. Increased long-term mortality was associated with PHF and high preoperative NT-proBNP, but not with preoperative or postoperative diastolic dysfunction. Cox regression revealed the following independent risk factors for long-term mortality: diabetes, renal dysfunction, preoperative NT-proBNP>960 ng/L, age, and male gender. Conclusions Surgery for aortic stenosis improved diastolic function in patients with high LV filling pressure in 50% of the patients. Our results could not confirm the previously suggested role of diastolic dysfunction as a marker for poor long-term survival after SAVR. Our findings showed that both PHF and high preoperative NT-proBNP were associated with long-term mortality.

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Section: Plos Onesupporting

confidence: 90%

Evaluation of left ventricular diastolic function in patients operated for aortic stenosis

et al. 2022

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“…Moreover, the monitoring of it could prevent postoperative complications ( 10 , 11 ). Moreover, the plasma NT-proBNP levels of patients would continue to rise after open-heart surgery ( 12 ). The results of the present study showed that the NT-proBNP of patients of both groups increased after operation, which might be affected by anesthesia, surgical trauma, hemodynamic abnormalities, inflammatory stimulation, CPB, myocardial damage and decreased contractile ability.…”

Section: Discussionmentioning

confidence: 99%

Protective effects of recombinant human brain natriuretic peptide in perioperative period during open heart surgery

Bao

et al. 2018

Exp Ther Med

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The aim of the present study was to evaluate the protective effects and safety aspects of recombinant human brain natriuretic peptide (rhBNP) on cardiac functions of patients undergoing open-heart surgery during perioperative period. In total, 150 patients undergoing open heart surgery in the Second Hospital of Shandong Universty from August 2015 to July 2016 were randomly divided into control group and observation group each with 75 cases. Patients in control group were treated by routine rehabilitation while patients in the observation group were treated by both the routine rehabilitation and rhBNP. All the observations were made before operation, after operation and 7 days after operation. The changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) of patients, the left ventricular ejection fraction (LVEF), cardiac function [Cardiac output (CO), pulmonary capillary wedge pressure (PAWP) and central venous pressure (CVP)] of patients were measured. Further, respirator support time, ICU stay time, incidence of complications and vital signs (BP, HR, SaO2) of patients in the two groups were also compared. NT-proBNP levels of all patients improved after operation but it decreased in both groups after 7 days of operation. The decrease of NT-proBNP levels in observation group was significantly higher than that of control group. Whereas, LVEF, CO, PAWP and CVP of patients in both the groups increased after operation but effects were significantly higher in the observation group after 7 days of medication. Respirator support time and ICU stay time of patients in observation group were significantly shorter than those in control group, and the incidence of postoperative complications of patients in the observation group were significantly lower than the control group. Moreover, BP, HR and SaO2 of patients in observation group were significantly elevated in comparison to control group (P<0.05). Recombinant human brain natriuretic peptide (rhBNP) could significantly improve the cardiac functions of patients after open heart surgery, and is safe as well as reliable.

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“…In the present study, NT-proBNP was found to be the sole predictor of high preoperative LV filling pressure, after adjusting for confounders. Additionally, previous studies have shown an association between NT-proBNP and diastolic function 37,[147][148][149][150] . Our method for the evaluation of high LV filling pressure, starting with E/A taking the age adjusted normal ranges into account for grading of diastolic function, was at least as good as left atrial index and E/é in identifying patients with increased levels of NT-proBNP.…”

Section: Diastolic Dysfunction Nt-probnp and Phfmentioning

confidence: 90%

Implications of myocardial dysfunction before and after aortic valve intervention

Hultkvist

2019

Linköping University Medical Dissertations

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Correlation to NT-ProBNP and Remodeling after Cardiac Surgery

Cited by 5 publications

References 24 publications

Evaluation of left ventricular diastolic function in patients operated for aortic stenosis

Evaluation of left ventricular diastolic function in patients operated for aortic stenosis

Protective effects of recombinant human brain natriuretic peptide in perioperative period during open heart surgery

Implications of myocardial dysfunction before and after aortic valve intervention

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