title: Perioperative serum brain natriuretic peptide and cardiac troponin in elective intracranial surgery.
abstract: BACKGROUND
  There are some intracranial insults which are associated with cardiac abnormalities. Studies of these abnormalities have never been carried out in elective intracranial neurosurgery for the removal of brain tumors. Our prospective study aims at quantifying serum cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after elective intracranial neurosurgery for tumor resection in patients with no history of cardiac abnormality.
  
  
  METHODS
  Pre- and postoperative serum cTnT and NT-proBNP were measured in 108 patients submitted to elective major intracranial surgery for the removal of neoplastic lesions. We tested potentially predictive models for these biomarker serum levels.
  
  
  RESULTS
  cTnT was undetectable both before and after surgery. Median (IQR) basal NT-proBNP was 35 (18-69) pg/mL and 110 (51-191) pg/mL after surgery. In a multiple linear regression model, basal NT-proBNP was predicted by age, gender, BMI, and the presence of "mass effect" (midline shift or effaced perimesencephalic cisterns on preoperative CT scan) (whole model P < 0.0001; R (2) = 0.3502; and Adjusted R (2) = 0.3247). Postoperative NT-proBNP increase was predicted by baseline NT-proBNP level (whole model P < 0.0001; R (2) = 0.5106; and Adjusted R (2) = 0.5052).
  
  
  CONCLUSIONS
  An intracranial mass effect is associated with higher NT-proBNP serum levels in patients with a brain neoplasm. Following elective intracranial surgery for brain tumor resection NT-proBNP values increase.
authors.affiliation: Anesthesia and Neurointensive Care, Department of Head and Neck, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy. ruggieri.francesco@hsr.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Ruggieri
authors.forename: Marco
authors.initials: M
authors.lastname: Gemma
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Calvi
authors.forename: Elisa
authors.initials: E
authors.lastname: Nicelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Agarossi
authors.forename: Luigi
authors.initials: L
authors.lastname: Beretta
mesh_terms: D000328:Adult; D000769:Anesthesia, Inhalation / Q000706:statistics & numerical data; D000771:Anesthesia, Intravenous / Q000706:statistics & numerical data; D015415:Biomarkers / Q000097:blood; D001932:Brain Neoplasms / Q000453:epidemiology / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005910:Glioma / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D010446:Peptide Fragments / Q000097:blood*; D059035:Perioperative Period; D011183:Postoperative Complications / Q000097:blood* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain