Changes in natriuretic peptides following passive containment surgery in heart failure patients with dilated cardiomyopathy.
To evaluate the influence on circulating plasma levels of natriuretic peptides following passive containment surgery in heart failure patients with dilated cardiomyopathy, thirteen patients with dilated cardiomyopathy subjected to cardiac surgery received the Acorn Cardiac Support Device. Patients with ischemic cardiomyopathy (n=7) underwent coronary artery bypass surgery receiving 2-3 bypass grafts. In the idiopathic cardiomyopathy group (n=6), mitral valve plasty was performed in five patients while one patients received the Cardiac Support Device only. Circulating plasma atrial natriuretic peptide, brain natriuretic peptide and C-type natriuretic peptide were measured in all patients before surgery and 12 months postoperatively. Following surgery there was a significant decrease in circulating plasma levels of brain natriuretic peptide (0.14+/-0.04 ng/ml vs. 0.06+/-0.03 ng/ml, P<0.05). No significant changes were seen in circulating plasma levels of atrial natriuretic peptide or C-type natriuretic peptide. NYHA functional class improved (2.7+/-0.1 vs. 1.8+/-0.2, P<0.001). The 6-min-walk increased (354+/-35 m vs. 473+/-31 m, P<0.01). There was a decrease in left ventricular end diastolic diameter (73+/-2 mm vs. 65+/-2 mm, P<0.001) and left ventricular end systolic diameter (65+/-2 mm vs. 56+/-3 mm, P<0.01). Following passive containment surgery using the ACORN Cardiac Support Device functional improvement and reversed remodelling is accompanied by decreased BNP levels.
Bredin
Fredrik
F
Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. fredrik.bredin@karolinska.se
Liska
Jan
J
Franco-Cereceda
Anders
A
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D020098:Natriuretic Peptide, C-Type / Q000097:blood; D020127:Recovery of Function; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D016138:Walking
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D020098:Natriuretic Peptide, C-Type; D009320:Atrial Natriuretic Factor