Significance of Serum Atrial and Brain Natriuretic Peptide Release After Coronary Artery Bypass Grafting

Watanabe, Masahiro; Egi, Koso; Hasegawa, Satoru; Tanaka, Hiroyuki; Ohshima, Hisanaga; Sakamoto, Tohru; Sunamori, Makoto

doi:10.1007/s00595-003-2580-9

Cited by 21 publications

(18 citation statements)

References 11 publications

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“…The increase of plasma BNP was correlated to the preoperative BNP value in our patients and in other studies [21,23]. The reported mean peak values of plasma BNP after coronary bypass grafting vary from 100 to 1265 pg/ml without differences regarding the time of extracorporal circulation or aortic cross-clamping [21,24 -26].…”

Section: Discussionsupporting

confidence: 48%

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Koch

Kitzsteiner

Zink

et al. 2007

International Journal of Cardiology

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Section: Discussionsupporting

confidence: 48%

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Koch

Kitzsteiner

Zink

et al. 2007

International Journal of Cardiology

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“…However, the mechanism of the elevated postoperative BNP and NT‐proBNP concentrations remains unclear. Plasma BNP concentration was found to increase remarkably in graft failure and heart failure after CABG surgery [7]. BNP level also was associated with endothelin‐1 concentration in failing human hearts [20].…”

Section: Discussionmentioning

confidence: 99%

“…The B-type natriuretic peptide (BNP) is a neurohormone mainly secreted from cardiac ventricles by increasing ventricular wall stress and volume expansion [6]. There are several previous studies that demonstrated that serum BNP concentration significantly increased after CABG surgery and was associated with increasing postoperative mortality and cardiac events [7,8]. Furthermore, ProBNP, a serum protein comprising 108 amino acids, can be cleaved into physiologically active BNP and biologically inactive Nterminal proBNP (NT-proBNP), whose plasma concentration reflects the activity of de novo synthesis and may have even greater specificity to cardiac activity than BNP [9].…”

Section: Introductionmentioning

confidence: 99%

Plasma B‐type natriuretic peptide in predicting outcomes of elective coronary artery bypass surgery

Chen

Lin

Shih

et al. 2013

The Kaohsiung J of Med Scie

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The risks of surgery and its clinical outcome are of great importance for both patients and physicians when choosing coronary artery bypass (CABG) surgery for coronary artery disease. The purpose of the current study was to clarify the relationship between serum B-type natriuretic peptide (BNP) and patient clinical outcome. Seventy-six eligible patients who underwent CABG were enrolled into the prospective study. Venous blood samples were drawn for serum BNP and N-terminal (NT)-proBNP levels measurement on preoperative Day 1, postoperative Day 1, and postoperative Day 7. Clinical end points were: (1) intensive care unit (ICU) stay longer than 4 days postoperatively and/or hospital stay longer than 13 days postoperatively; (2) major complications and poor outcomes. Patients who had prolonged ICU stay and hospitalization had significantly higher postoperative Day 1 BNP and postoperative Day 1 NT-proBNP level (p = 0.02 and 0.005, respectively). Age was significantly older in patients with prolonged ICU stay and hospitalization than those without prolonged ICU stay and hospitalization (p = 0.03). Serum creatinine level was also significantly increased in patients with prolonged ICU stay and hospitalization (p = 0.009). However, age was the only remaining factor that correlated with prolonged ICU stay and hospitalization in the multivariate logistic regression model. These results suggest that research using BNP and NT-proBNP for predicting ICU stay and hospitalization in patients who have undergone CABG must adjust risk factors to present a more appropriate estimation of its clinical outcome.

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“…A preoperative BNP level >385 pg/mL is consistent with an increased risk of morbidity and mortality immediately after surgery and at 1 year [19]. Corroborative studies have demonstrated that perioperative elevations in BNP are a strong predictor of postoperative atrial fibrillation, pleural effusions, and increased 2-year mortality risk [20][21][22]. An additional study has also demonstrated the efficacy of BNP as a postoperative surrogate of success with surgical ventricular restoration.…”

Section: Effects Of Bnp In Cardiac Surgery Patientsmentioning

confidence: 89%

Practical Application of Human B-Type Natriuretic Peptide as a Therapeutic Intervention in the Perioperative Setting

Feldman

Sun

2005

Heart Fail Rev

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The use of human B-type natriuretic peptide (BNP, nesiritide) as a therapeutic intervention is now well established for patients with acute decompensated heart failure. Nesiritide mimics the actions of endogenous BNP by binding to and stimulating receptors in the heart, kidney, and vasculature. Postsurgical patients are typically managed with various combinations of vasodilators, diuretics, and inotropes. Many of these therapeutic interventions lack significant proof of efficacy and are potentially deleterious to these patients, despite the acute hemodynamic improvement that results from their use. Use of nesiritide may supplant some of these therapies as an equally efficacious and possibly safer alternative in patients with decompensated heart failure. Nesiritide is a unique, balanced vasodilator that markedly decreases the signs and symptoms of heart failure in perioperative patients, and also may decrease the need for inotropic agents. This review summarizes nesiritide's mechanism of action and addresses special concerns and practical considerations for cardiothoracic surgeons and anesthesiologists. Overall, nesiritide appears to be an effective and safe therapeutic option in perioperative patients with decompensated heart failure.

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Significance of Serum Atrial and Brain Natriuretic Peptide Release After Coronary Artery Bypass Grafting

Abstract: The BNP concentration after CABG was found to be corrected with interim clinical status after surgery. Thus, it may be necessary for patients with a high postoperative BNP concentration to be closely monitored for coronary events.

Cited by 21 publications

References 11 publications

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Impact of cardiac surgery on plasma levels of B-type natriuretic peptide in children with congenital heart disease

Plasma B‐type natriuretic peptide in predicting outcomes of elective coronary artery bypass surgery

Practical Application of Human B-Type Natriuretic Peptide as a Therapeutic Intervention in the Perioperative Setting

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