title: N-terminal pro-Brain natriuretic peptide as a useful biomarker for monitoring prognosis in patients with cardiac valve replacement.
abstract: BACKGROUND
  N-terminal pro-Brain natriuretic peptide (NT-proBNP) is an important biomarker to indicate cardiac function, but its significance in cardiac surgery is still unclear.
  
  
  OBJECTIVE
  To explore clinical significance of serum NT-proBNP and their dynamic characteristics in patients with cardiac valve replacement (CVR).
  
  
  METHODS
  Dynamically detecting pre-operative and postoperative serum NT-proBNP on Elecsys 2010 in 60 CVR patients.
  
  
  RESULTS
  (1) There was a good relationship between pre-operative NT-proBNP and pre-operative NYHA classification, ejection fraction, fractional shortening, or between postoperative 1 day log [NT-proBNP] and postoperative ICU time, correlation coefficients were respectively 0.426 (P=0.001), -0.465 (P=0.001), -0.463 (P=0.002), and 0.453 (P=0.006). (2) Pre-operative NT-proBNP would be higher in multivalves damage or mitral lesions patients than that in single valve damage or aortic lesions. It indicated NT-proBNP>1,352 pg/ml could discriminate multivalves damage in Rheumatic Heart Diseases (RHD) patients (sensitivity: 0.742; specificity: 0.64); and NT-proBNP>549.12 pg/ml could differentiate mitral lesions and aortic lesions (sensitivity: 0.92; specificity: 0.75). However, pre-operative serum NT-proBNP for differentiating atrial fibrillation and sinus arrhythmia was not most efficient (AUC=0.655; P=0.044). (3) Perioperative NT-proBNP in CVR patients was characterized by early postoperative NT-proBNP increasing and late postoperative NT-proBNP decreasing. The peak of postoperation NT-proBNP was at postoperative 7 days.
  
  
  CONCLUSIONS
  Serum NT-proBNP was not only a good biomarker to effectively evaluate heart function but also to evaluate the cardiac valve damage in RHD patients, and postoperative NT-proBNP dynamic determination, especially detecting postoperative 1 day, 7 days and 14 days NT-proBNP would be more useful to evaluate prognosis of CVR patients.
authors.affiliation: Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Cai
authors.forename: Lanlan
authors.initials: L
authors.lastname: Wang
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
authors.forename: Yingkang
authors.initials: Y
authors.lastname: Shi
authors.forename: Yingqiang
authors.initials: Y
authors.lastname: Guo
mesh_terms: D001145:Arrhythmias, Cardiac / Q000097:blood / Q000150:complications / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D005260:Female; D006334:Heart Function Tests; D006350:Heart Valve Prosthesis; D006351:Heart Valves / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D019990:Perioperative Care; D011182:Postoperative Care; D011379:Prognosis; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain