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Changes in natriuretic peptides following passive containment surgery in heart failure patients with dilated cardiomyopathy

Section of Cardiothoracic Surgery and Anesthesiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, S-171 76 Stockholm, Sweden

*Corresponding author. Tel.: +46-8-517 791 77; fax: +46-8-32 27 01.

E-mail address: fredrik.bredin{at}karolinska.se (F. Bredin).

To evaluate the influence on circulating plasma levels of natriuretic peptides following passive containment surgery in heart failure patients with dilated cardiomyopathy, thirteen patients with dilated cardiomyopathy subjected to cardiac surgery received the Acorn Cardiac Support Device. Patients with ischemic cardiomyopathy (n=7) underwent coronary artery bypass surgery receiving 2–3 bypass grafts. In the idiopathic cardiomyopathy group (n=6), mitral valve plasty was performed in five patients while one patients received the Cardiac Support Device only. Circulating plasma atrial natriuretic peptide, brain natriuretic peptide and C-type natriuretic peptide were measured in all patients before surgery and 12 months postoperatively. Following surgery there was a significant decrease in circulating plasma levels of brain natriuretic peptide (0.14±0.04 ng/ml vs. 0.06±0.03 ng/ml, P<0.05). No significant changes were seen in circulating plasma levels of atrial natriuretic peptide or C-type natriuretic peptide. NYHA functional class improved (2.7±0.1 vs. 1.8±0.2, P<0.001). The 6-min-walk increased (354±35 m vs. 473±31 m, P<0.01). There was a decrease in left ventricular end diastolic diameter (73±2 mm vs. 65±2 mm, P<0.001) and left ventricular end systolic diameter (65±2 mm vs. 56±3 mm, P<0.01). Following passive containment surgery using the ACORN Cardiac Support Device functional improvement and reversed remodelling is accompanied by decreased BNP levels.

Key Words: Cardiac support device; Dilated cardiomyopathy; Heart failure; Natriuretic peptides