title: Natriuretic peptides after pulmonary resection.
abstract: BACKGROUND
  Little is known about alterations in the levels and influence of natriuretic peptide (NP) on cardiopulmonary function after pulmonary resection for lung cancer. This study was designed to investigate the patterns and activity of NP after pulmonary resection.
  
  
  METHODS
  We investigated changes in plasma A-type (atrial) NP and B-type (brain) NP (BNP) using radioimmunoassay, in lung cancer patients before and after lobectomy (n = 15) or pneumonectomy (n = 10). Patient characteristics, respiratory function, operative time, blood loss, intraoperative fluid administration, and intraoperative urine output in both groups were also compared. Pulmonary hemodynamic variables were monitored continuously.
  
  
  RESULTS
  Plasma concentrations of A-type NP and BNP did not differ between the two groups preoperatively. However, the group undergoing pneumonectomy exhibited higher concentrations of A-type NP and BNP than the group undergoing lobectomy on postoperative days 3 and 7. Alterations in A-type NP and BNP after pulmonary resection therefore differed according to the volume of lung tissue resected. Both mean pulmonary artery pressure and total pulmonary vascular resistance increased significantly in the pneumonectomy group. The total pulmonary vascular resistance on postoperative day 3 correlated with the plasma BNP concentration in the pneumonectomy group.
  
  
  CONCLUSIONS
  A-type NP and BNP effectively compensate for the right ventricular dysfunction noted after pulmonary resection, and this is more evident after pneumonectomy than after lobectomy. Changes in ventricular activity associated with changes in plasma BNP and total pulmonary vascular resistance are indicative of cardiopulmonary adjustments after pneumonectomy.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Japan. ktayama@kkr.sasebo.nagasaki.jp
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Tayama
authors.forename: Shinzo
authors.initials: S
authors.lastname: Takamori
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mitsuoka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashi
authors.forename: Kohichi
authors.initials: K
authors.lastname: Tamura
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Mifune
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply; D008175:Lung Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000097:blood*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D011863:Radioimmunoassay; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor