title: Myocardial protective effect of human atrial natriuretic Peptide in cardiac surgery. -hANP Shot” in clinical safety trial-.
abstract: BACKGROUND
  We studied low-dose human atrial natriuretic peptide (hANP) infusion therapy during cardiac surgery and reported the cardiac and renal protective effects. The efficacy of a bolus injection of hANP (the "hANP shot") simultaneously with induction of cardioplegia has been proven in animal experiments. In the present study the clinical effects of this "hANP shot" were examined.
  
  
  RESULTS
  The subjects were 67 patients undergoing Coronary artery bypass grafting. At the time of inducing cardioplegia, 1 group received a simultaneous bolus injection of 100 μg of hANP (hANP group) and the other group received an injection of physiological saline (placebo group). The primary endpoints were (1) operative mortality and complications, and (2) the creatine kinase isoenzyme MB (CPK-MB), troponin-I, and human heart fatty acid binding protein (H-FABP) levels. The secondary endpoints were (1) the incidence of arrhythmia, and levels of (2) atrial and B-type natriuretic peptides, and cyclic guanosine monophosphate (cGMP), and (3) renin, angiotensin II, and aldosterone. Postoperative CPK-MB, troponin-I, and H-FABP levels were significantly lower in the hANP group than in the placebo group. Postoperative arrhythmia was significantly less frequent in the hANP group than in the placebo group.
  
  
  CONCLUSIONS
  It is possible to achieve cardioprotective effects based on the safety of the "hANP shot", as well as from biomarkers of ischemia and results related to arrhythmia. The "hANP shot" should also be evaluated as a safer and new cardioprotective method for cardiac surgery.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. asezai.med@gmail.com
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Kenji
authors.initials: K
authors.lastname: Akiyama
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.forename: Satoshi
authors.initials: S
authors.lastname: Unosawa
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000368:Aged; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage* / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass; D052279:Creatine Kinase, MB Form / Q000097:blood; D006152:Cyclic GMP / Q000097:blood; D004305:Dose-Response Relationship, Drug; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*; D012083:Renin / Q000097:blood; D019210:Troponin I / Q000097:blood
chemical_list: D002316:Cardiotonic Agents; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D019210:Troponin I; D000804:Angiotensin II; D020097:Natriuretic Peptide, Brain; D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D052279:Creatine Kinase, MB Form; D012083:Renin; D006152:Cyclic GMP