Perioperative changes aminoterminal fragment of brain natriuretic peptide (NT-proBNP) in elderly patients operated on under general and spinal anesthesia

Abstract

Natriuretic peptide and NT-proBNP is widely used to predict perioperative cardiac complications. In 62 elderly patients with concomitant cardiovascular disease were performent open prostatectomy surgery. In 32 patients had general anesthesia, 30 - spinal anesthesia. In the early postoperative period in the group with spinal anesthesia, recorded an increase in NT-proBNP more than 2 times. Regression of spinal block creates conditions for volume overload in patients with concomitant cardiovascular disease. Laboratory monitoring of NT-proBNP in the perioperative period in patients with concomitant cardiovascular disease can help indentify patients with preclinical form of heart failure and conduct timely corrective therapy.

Keywords

NT-proBNP / NT-proBNP / spinal anesthesia / heart failure

References

[1] Андреев Д.А. Натрийуретические пептиды B-типа при сердечной недостаточности: диагностика, оценка прогноза и эффективности лечения // Лабораторная медицина. 2003; 6: 42-46.

[2] Козлов И.А., Харламова И.Е. Повышенный уровень натрийуретического пептида В-типа (NT-proBNP) как фактор риска у кардохирургических больных // Общая реаниматология. 2010; VI (1): 49-55.

[3] Мороз В.В., Добрушина О.Р., Стрельникова Е.П., Корниенко А.Н., Зинина Е.П. Предикторы кардиальных осложнений операций на органах брюшной полости и малого таза у больных пожилого и старческого возраста // Общая реаниматология. 2011; VII (5): 28-33.

[4] Мороз В.В., Никифоров Ю.В., Кричевский Л.А., Асеев В.М., Гусева О.Г. и др. Значение сердечного пептида NT-proBNP в оценке риска реваскуляризации миокарда у больных со сниженной фракцией изгнания левого желудочка // Общая реаниматология. 2010; VI (2): 38-42.

[5] Шумаков Д.В., Шевченко О.П., Орлова О.В. и др. Прогностическое значение натрийуретического пептида B-типа у кардиохирургических больных // Вестн. трансплантологии и искусств. органов. 2007; (1): 54-61.

[6] Allanore Y., Borderie D., Meune C. et al. N-terminal pro-brain natriuretic peptide as a diagnostic marker of early pulmonary artery hypertension in patients with systemic sclerosis and effects of calcium-channel blockers // Arthritis Rheum. 2003; (48): 3503-3508.

[7] Alter P., Rupp H., Rominger M.B., Vollrath A. et al. B-type natriuretic peptide and wall stress in dilated human heart // Mol Cell Biochem. 2008; 314: 179-191.

[8] Azzazy H.M., Christenson R.H. B-type natriuretic peptide: physiologic role and assay characteristics // Heart Fail. Rev. 2003; 8: 315-320.

[9] Bibbins-Domingo K., Gupta R., Na B., Wu Alan H.B., Schiller N.B., Whooley M.A. N-Terminal Fragment of the Prohormone Brain-Type Natriuretic Peptide (NT-proBNP), Cardiovascular Events, and Mortality in Patients With Stable Coronary Heart Disease // JAMA. 2007; 297 (2): 169176.

[10] De Bold A.J. Atrial natriuretic factor: a hormone produced by the heart // Science. 1985; 230 (4727): 767-770.

[11] De Bold A.J., Boreinstein H.B., Veress A.T., Sonnenberg H.A. A rapid and potent natriuretic respons to intravenous injection of atrial myocardial extract in rats // Life Sci. 1981; 8: 89-94.

[12] De Bold A.J. Thirty years of research on atrial natriuretic factor: historical background and emerging concepts // Can. J. Physiol. Pharmacol. 2011; 89 (8): 527-531.

[13] Feringa H.H., Bax J.J., Elhendy A., de Jonge R. et al. Association of plasma N-terminal pro B-type natriuretic peptide with postoperative cardiac events in patients undergoing surgery for abdominal aortic aneurysm or leg bypass // Am. J. Cardiol. 2006; 98: 111-115.

[14] Franke J., Frankenstein L., Schellberg D., Bajrovic A. et al. Is there an additional benefit of serial NT-proBNP measurements in patients with stable chronic heart failure receiving individually optimized therapy? // Clinical Research in Cardiology. 2011; 100 (12): 1059-1067.

[15] Hall C. Essential biochemistry and physiology ofNT-proBNP // Eur. J. Heart. Fail. 2004; 6 (3): 257-260.

[16] Hildebrandt P., Boesen M., Olsen M. et al. N-terminal pro brain natriuretic peptide in arterial hypertension - a marker for leftventricular dimensions and prognosis // Eur. J. Heart Fail. 2004; 15: 313-317.

[17] Jacobs L.H., Mingels A.M., Wodzig W.K., van Dieijen-Visser M.P., Kooman J.P. Renal dysfunction, hemodialysis, and the NT-proBNP/BNP ratio // Am. J. Clin. Pathol. 2010; 134 (3): 516-517.

[18] Jakobsen C.J., Bhavsar R., Nielsen D.V., Ryhammer P.K. et al. High Thoracic Epidural Analgesia in Cardiac Surgery: Part 1-High Thoracic Epidural Analgesia Improves Cardiac Performance in Cardiac Surgery Patients // J. Cardiothorac. Vasc. Anesth. 2012; Jul 5. [Epub ahead of print].

[19] Kaneko T. Preoperative NT-proBNP predicts perioperative cardiac events in hip joint fracture surgery of the elderly // Masui. 2012; 61 (6): 574-578.

[20] Mahla E.M., Baumann A., Rehak P. et al. N-terminal probrain natriuretic peptide identifies patients at high risk for adverse cardiac outcome after vascular surgery // Anesthesiology. 2007; 106: 1088-1095.

[21] Maron B.J., Tholakanahalli V.N., Zenovich A.G. et al. Usefulness of B-type natriuretic peptide assay in the assessment of symptomatic state in hypertrophic cardiomyopathy // Circulation. 2004; 109: 984-989.

[22] Noveanu M., Hartwiger S., Mueller C. What anesthesiologists should know about B-type natriuretic peptide // Minerva Anestesiol. 2009; 75: 698-702.

[23] Ogata K., Fukusaki M., Miyako M., Tamura S. et al. The effects of colloid preload on hemodynamics and plasma concentration of atrial natriuretic peptide during spinal anesthesia in elderly patients // Masui. 2003; 52 (1): 20-25.

[24] Omland T., Persson A., Ng L. et al. N-terminal pro-B-type natriuretic peptide and long-term mortality in acute coronary syndromes // Circulation. 2002; 106: 2913-2918.

[25] Prnjavorac B., Abduzaimović K., Jukić J., Sejdinović R. et al. Use of amino-terminal pro-B type natriuretic peptide as the parameter for long-term monitoring of water overload in patient with chronic kidney diseases // Med. Glas. Ljek komore Zenickodoboj kantona. 2011; 8 (1): 116-120.

[26] Ryding, Alisdair D.S. Kumar, Saurabh, Worthington, Angela M., Burgess, David. Prognostic Value of Brain Natriuretic Peptide in Noncardiac Surgery: A Meta-analysis // Anesthesiology. 111 (2): 311-319.

[27] Sudoh T., Kangawa K., Minamino N., Matsuo H. A new natriuretic peptide in porcine brain // Nature. 1988; 3: 332 (6159): 78-81.

[28] Sudoh T., Kangawa K., Minamino N., Vatsuo H. C-type natriuretic peptide: a new member of natriuretic peptide family identified in porcin brain // Biochem. Biophys. Res. Commun. 1990; 168: 863-870.

[29] Suttner S., Lang K., Piper S.N., Schultz H. et al. Continuous intra- and postoperative thoracic epidural analgesia attenuates brain natriuretic peptide release after major abdominal surgery // Anesth Analg. 2005; 101 (3): 896-903.

[30] Van Kimmenade R.R., Pinto Y.M., Bayes-Genis A., Lainchbury J.G., Richards A.M., Januzzi J.L. Jr. Usefulness of intermediate amino-terminal pro-brain natriuretic peptide concentrations for diagnosis and prognosis of acute heart failure // Am. J. Cardiol. 2006; 98 (3): 386-390.

[31] Weber M., Hamm C. Role of B-type natriuretic peptide (BNP) and NTproBNP in clinical routine // Heart. 2006; 92: 843-849.

[32] Yeh H.M., Lau H.P., Lin J.M. et al. Preoperative plasma N-terminal pro-brain natriuretic peptide as a marker of cardiac risk in patients undergoing elective non-cardiac surgery // Br. J. Surg. 2005; 92: 1041-1045.

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