title: Plasma vasopressin levels in patients with right-sided heart dysfunction and chronic thromboembolic pulmonary hypertension (CTEPH).
abstract: OBJECTIVE
  Patients with left-sided heart dysfunction and volume overload often have associated elevations in vasopressin from neuroendocrine activation. The authors investigated perioperative levels of vasopressin in patients with isolated right-sided heart dysfunction from chronic thromboembolic pulmonary hypertension.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Single center, tertiary hospital.
  
  
  METHODS
  Patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary thromboendarterectomy.
  
  
  METHODS
  Vasopressin levels were measured in 22 patients during the perioperative period.
  
  
  RESULTS
  Vasopressin was undetectable in 8/22 patients at baseline. As a group, vasopressin levels at baseline and after induction of anesthesia were 0.8 pg/mL (median; 0.5-1.5, interquartile range of 25% and 75%) and 0.7 pg/mL (median; 0.5-1.4, interquartile range of 25% and 75%), respectively. During cardiopulmonary bypass (CPB), vasopressin increased to 13.9 pg/mL (median; 6.7-19.9, interquartile range of 25% and 75%). Vasopressin remained elevated after deep hypothermic circulatory arrest (DHCA) at 10.5 pg/mL (median; 6.5-19.9 interquartile range of 25% and 75%) and after CPB at 19.9 pg/mL (median; 11.1-19.9 interquartile range of 25% and 75%).
  
  
  CONCLUSIONS
  Vasopressin levels in PTE patients are in the low-to-normal range at baseline and may be a clinically relevant issue in the hemodynamic management of PTE.
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, San Diego, CA. Electronic address: Liem@ucsd.edu.
authors.forename: Liem
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, San Diego, CA; Department of Anesthesiology, Veterans Affairs San Diego Health Care System, San Diego, CA.
authors.forename: Dalia
authors.initials: D
authors.lastname: Banks
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, San Diego, CA; Department of Anesthesiology, Veterans Affairs San Diego Health Care System, San Diego, CA.
authors.forename: Gerard
authors.initials: G
authors.lastname: Manecke
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, San Diego, CA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Shurter
authors.affiliation: Department of Anesthesiology, Veterans Affairs San Diego Health Care System, San Diego, CA.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Schilling
authors.affiliation: Department of Anesthesiology, Veterans Affairs San Diego Health Care System, San Diego, CA.
authors.forename: Hemal H
authors.initials: HH
authors.lastname: Patel
authors.affiliation: Department of Cardiothoracic Surgery, University of California San Diego Medical Center and Sulpizio Cardiovascular Center, San Diego, CA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Madani
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, San Diego, CA; Department of Anesthesiology, Veterans Affairs San Diego Health Care System, San Diego, CA.
authors.forename: David M
authors.initials: DM
authors.lastname: Roth
mesh_terms: D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D003914:Dextrocardia / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006324:Heart Arrest, Induced; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014667:Vasopressins / Q000097:blood*; D055815:Young Adult
chemical_list: D014667:Vasopressins
keywords: chronic thromboembolic pulmonary hypertension (CTEPH); neuroendocrine activation; pulmonary thromboendarterectomy (PTE); right-sided heart dysfunction; vasopressin deficiency