Perioperative levels of atrial natriuretic peptide and troponin-T in patients with uncomplicated coronary artery surgery.
BACKGROUND



OBJECTIVE
increased ANP levels after uncomplicated coronary artery surgery (CAS) indicate functional reduction.


METHODS



METHODS
prospective, randomized. Preoperative upto the 12 week postoperative.


METHODS
Thoracic and Cardiovascular Surgery, University of Düsseldorf.


METHODS
15 patients (mean age: 58+/-6.1 years; 13 months, 2 weeks; no myocardial infarction, no congestive heart failure) with 3 vessel disease.


METHODS
levels of atrial natriuretic peptide (ANP) (pg/ml; radioimmunoassay), Troponin T (TnT) (ng/ml; ELISA test), haemodynamic parameters, ECG monitoring, m-mode echocardiography (Echo).


METHODS
increase of ANP, TnT levels during extracorporeal circulation (ECC), decrease after operation.


RESULTS
Maximal increase of ANP from preoperative 90+/-10 (M+/-SEM) pg/ml (p<0.05) up to intraoperative 380+/-38 pg/ml. Ten days postoperative ANP (26+/-33 pg/ml) still threefold increased compared to preoperative level. Increasement of TnT from preoperative 0.02+/-0.01 ng/ml upto intraoperative 3.44+/-0.47 ng/ml. Ten days postoperative TnT concentration normal (0.13+/-0.11 ng/ml). Correlation of ANP and TnT five min after bypass up to 6 hrs postoperative (p<0.05, r =3.4). Increase of left atrial diameter preoperative 42.2+/-1.1 mm up to 46.8+/-1.2 mm (p<0.05) 10 days postoperative. LVEDD, EF changed from preoperative 51.1+/-0.9 mm, 73+/-2% to 54.5+/-1.2 mm, 65+/-4% 10 days postoperative.


CONCLUSIONS
Threefold increase of ANP 10 days postoperative and return of TnT levels to normal under consideration of datas of echo show, that ANP is suitable to indicate the meanterm, functional, myocardial reduction. Increased ANP levels, atrial dilatation and dysfunction are important signs of cardial functional reduction after CAS.
Langenbach
M R
MR
Department of Surgery, University Witten-Herdecke, Wuppertal, Germany.
Korbmacher
B
B
Schulte
H
H
Zirngibl
H
H
Grabensee
B
B
Plum
J
J
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000097:blood* / Q000601:surgery; D004108:Dilatation, Pathologic; D005112:Extracorporeal Circulation; D005260:Female; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D020107:Troponin T / Q000097:blood*; D018754:Ventricular Dysfunction / Q000097:blood
D020107:Troponin T; D009320:Atrial Natriuretic Factor