Interact CardioVasc Thorac Surg 2009;9:666. doi:10.1510/icvts.2008.189837A
© 2009 European Association of Cardio-Thoracic Surgery
eComment: Re: Brain natriuretic peptide a predictive marker in cardiac surgery
Leo A. Bockeria,
Olga L. Bockeria and
Uliana A. Kolesnikova
Bakoulev Scientific Center for Cardiovascular Surgery, Roublevskoye Sh 135, 121552 Moscow, Russia
Brain natriuretic peptide a predictive marker in cardiac surgery
The results of the study were thoroughly analyzed in the reviewed article. The level of BNP concentration in 141 patients undergoing cardiac surgery was measured prior to operation and their comorbidities were examined against their BNP [1]. These results fully reflect all objectives of the study which were the evaluation of the BNP predictor in postoperative patients and the detection of connection between the level of this marker and the postoperative prognosis. In particular, the authors revealed that high level of BNP before intervention was found in patients with renal impairment, peripheral vascular disease and low ejection fraction. In patients with high inotropic use and longer ventilation time BNP level was statistically higher than in patients with routine postoperative period. However, there was no predicting value of BNP marker in patients with atrial fibrillation and infection in early postoperative period.
In recent years, the study of neurohormonal activation and the role of BNP as a diagnostic and prognostic marker has taken a remarkable start [2]. BNP is a neurohormone which is synthesized in ventricular myocardium in response to increased wall stress. Pro-BNP marker (a terminal part of prohormone BNP) has a high diagnostic accuracy and predicting value due to longer stay in blood in comparison with BNP [3].
BNP marker is widely and regularly used at the Bakulev Center for Cardiovascular surgery. This marker can be useful in the diagnostic and long-term prognosis of different cardiac pathologies. It helps to estimate the heart failure grade, to define high-risk patients and conditions which lead to high operative mortality. BNP and pro-BNP markers now are defined as a good diagnostic tool in asymptomatic patients. BNP measurement assists in evaluating the efficacy of the medical treatment in outpatients in the short- and long-term follow-up period.
BNP level also allows to define patients with symptoms which require further research in order to choose the right algorithm of treatment [4].
 |
References
|
|---|
- Attaran S, Sherwood R, Desai J, Langworthy R, Mhandu P, John L, El-Gamel A. Interact CardioVasc Thorac Surg 2009;9:662–666.[Abstract/Free Full Text]
- Bettencourt P. NT-proBNP and BNP: biomarkers for heart failure management. Eur J Heart Fail 2004;6:359–363.[Abstract/Free Full Text]
- Vanderheyden M, Bartunek J, Goethals M. Brain and other natriuretic peptides: molecular aspects. Eur J Heart Fail 2004;6:261–267.[Abstract/Free Full Text]
- Suzuki S, Yoshimura M, Nakayama M, Mizuno Y, Harada E, Ito T, Nakamura S, Abe K, Yamamuro M, Sakamoto T, Saito Y, Nakao K, Yasue H, Ogawa H. Plasma level of B-type natriuretic peptide as a prognostic marker after acute myocardial infarction: a long-term follow-up analysis. Circulation 2004;110:1387–1391.[Abstract/Free Full Text]
Related Article
-
Brain natriuretic peptide a predictive marker in cardiac surgery
- Saina Attaran, Roy Sherwood, Jatin Desai, Rachel Langworthy, Peter Mhandu, Lindsay John, and Ahmed El-Gamel
Interactive CardioVascular and Thoracic Surgery 2009 9: 662-666.
[Abstract]
[Full Text]
[PDF]
|
|
Top
References