Original articleB-Type Natriuretic Peptide as a Predictor of Postoperative Heart Failure After Aortic Valve Replacement
Section snippets
Methods
Between September 2006 and October 2007, 161 patients undergoing AVR in the Department of Cardiothoracic Surgery at Lund University Hospital, Sweden, were included in the study. Exclusion criteria were aortic dissection, surgery on the aortic arch, and procedures including deep hypothermia with circulatory arrest. Valve pathology was determined by echocardiography and classified as degenerative calcification (n = 136), aortic insufficiency (n = 15), active endocarditis (n = 6), and structural
Results
The 30-day mortality was significantly higher in patients with heart failure (group II, 8.1%, 3/37) than in patients without postoperative heart failure (group I, 0.8%, 1/124; p = 0.038). The cause of death was cardiac-related in all patients (circulatory collapse, 4/4). The distribution of the BNP levels in the study population is presented in Figure 2. Patients in group 2 had a mean BNP value on arrival in the ICU (D0) of 379 ± 417 pg/mL (median 270 pg/mL ranging from 22-1,940), whereas the
Discussion
Postoperative HF after AVR still remains an important predictor of poor outcome.2, 3, 4 The present data showed that the 30-day mortality was more than 10-fold increased (8.1% v 0.8%) in patients with postoperative heart failure. The association between postoperative HF and 30-day mortality emphasizes the importance of early diagnosis and the initiation of adequate therapy in the ICU. BNP has been shown to be a reliable and easily accessible biomarker for diagnosing heart failure.8, 12
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2019, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Postoperative elevations have predicted prolonged intensive care unit stays of >4 days and in-hospital deaths in CABG patients in a male-predominant population.19 The extended use of an intra-aortic balloon pump or inotropic support for >24 hours was correlated strongly to high BNP levels drawn postoperatively in the intensive care unit in a small cohort of 169 patients undergoing aortic or mitral valve repair or replacement ± CABG.20 Murad et al. conducted a larger study of 499 patients after valve or CABG surgery and found that BNP values above 382 pg/mL were an independent predictor of 30-day mortality.21
Low-Cardiac-Output Syndrome After Cardiac Surgery
2017, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Preoperative levels of brain natriuretic peptide and the N-terminal of the prohormone brain natriuretic peptide in adult patients undergoing cardiac surgery have been shown to be predictors of prolonged inotropic support, hospitalization, and 30-day mortality.23,24 Furthermore, another study demonstrated that a brain natriuretic peptide level of>82 pg/mL at admission to the intensive care unit (ICU) in patients who underwent aortic valve surgery was an independent predictor of postoperative heart failure.25 Muehlschlegel et al prospectively studied a cohort of 1,298 patients undergoing primary CABG with CPB to assess the predictive value of heart fatty acid binding protein levels as early markers of perioperative myocardial injury, ventricular dysfunction, and all-cause mortality.26
Predictive value of plasma brain natriuretic peptide for postoperative cardiac complications-A systemic review and meta-analysis
2014, Journal of Critical CareCitation Excerpt :Systemic physiologic effects of natriuretic peptides (NPs) include natriuresis, diuresis, and vasodilation [4]. Several studies have shown its ability to predict perioperative major adverse cardiovascular events (MACE) including atrial or ventricular arrhythmia, myocardial infarction, or sudden cardiac death [5–31]. Several meta-analyses have demonstrated that increased NT-proBNP levels predict short- and longer term cardiac complications [4,32,33].
Postoperative increase in B-type natriuretic peptide levels predicts adverse outcome after cardiac surgery
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2011, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :This biomarker has been identified as an important clinical tool in perioperative care.55 A recent cluster of perioperative trials in adult cardiac surgery have all consistently shown the significant predictive value of B-type natriuretic peptide after cardiac surgery, including its utility to predict adverse outcome more precisely than currently validated outcome models.56-60 These trials complement the recent cluster of meta-analyses that have shown the significantly predictive value of this biomarker in noncardiac surgery, including vascular surgery.61-63