PMID- 17321144
OWN - NLM
STAT- MEDLINE
DCOM- 20070719
LR  - 20151119
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 31
IP  - 5
DP  - 2007 May
TI  - Changes in B-type natriuretic peptides after surgical ventricular restoration.
PG  - 922-8
AB  - OBJECTIVE: The aim of this study was to prospectively investigate changes in 
      brain natriuretic peptide (BNP) and amino terminal pro-BNP (NT-pro-BNP) in 
      relation to functional status after surgical ventricular restoration (SVR). 
      METHODS: Between March 2003 and May 2006, 29 patients (20 men and 9 women, mean 
      age 65 years, mean ejection fraction 24%) with post-infarction left ventricular 
      aneurysm and depressed left ventricular function underwent SVR according to the 
      Dor technique at our institution. Twenty-two patients (76%) were in New York 
      heart association (NYHA) functional class III or IV. Multi-vessel disease was 
      present in 26 patients. Natriuretic peptides, functional status, ejection 
      fraction and left ventricular volumes were analyzed at baseline, after 6 months, 
      and late postoperatively. RESULTS: There was no early mortality. Survival at 24 
      months was 93%. Six months postoperatively 25/29 (86%) patients were in NYHA 
      class I and II (p<0.001) and at late (mean 21 months) follow-up, all patients 
      were in NYHA class I and II. There was a persistent reduction of NT-pro-BNP (2406 
      pg/ml vs 1510 pg/ml; p=0.03 and 975 pg/ml; p=0.03) and BNP (312 pg/ml vs 228 
      pg/ml; p=0.12 and 191 pg/ml; p=0.20) 6 months postoperatively and at late 
      follow-up, respectively. Ejection fraction improved from 24% to 37% (p<0.001) at 
      6 months. End-diastolic (110 ml/m(2) vs 90 ml/m(2), p=0.009) and end-systolic (75 
      ml/m(2) vs 52 ml/m(2), p=0.006) volume index were reduced at 6 months. Functional 
      improvement correlated significantly with reduction in BNP (r=0.61, p=0.01) and 
      NT-pro-BNP (r=0.58, p=0.003) 6 months after surgery. Ejection fraction correlated 
      inversely with BNP (r=-0.58, p=0.02) and NT-pro-BNP (r=-0.51, p=0.04), and 
      end-systolic volume correlated with BNP (r=0.65, p=0.03) and NT-pro-BNP (r=0.62, 
      p=0.03) 6 months after surgery. CONCLUSIONS: Heart failure secondary to 
      post-infarction left ventricular remodeling can be reversed by SVR. Improvement 
      in these patients was associated with reduced levels of B-type natriuretic 
      peptides 6 months after surgery. Clinical improvement was maintained and peptide 
      levels were further reduced at late follow-up.
FAU - Sartipy, Ulrik
AU  - Sartipy U
AD  - Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University 
      Hospital, Stockholm, Sweden. Ulrik.Sartipy@karolinska.se
FAU - Albage, Anders
AU  - Albage A
FAU - Larsson, Per Thomas
AU  - Larsson PT
FAU - Insulander, Per
AU  - Insulander P
FAU - Lindblom, Dan
AU  - Lindblom D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070223
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - 0 (Biomarkers)
RN  - 0 (Peptide Fragments)
RN  - 0 (Protein Precursors)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/analysis
MH  - Cardiac Surgical Procedures/methods
MH  - Female
MH  - Heart Aneurysm/etiology/*metabolism/surgery
MH  - Heart Ventricles/metabolism/surgery
MH  - Humans
MH  - Magnetic Resonance Angiography/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/complications/metabolism
MH  - Natriuretic Peptide, Brain/*analysis
MH  - Peptide Fragments/analysis
MH  - Prospective Studies
MH  - Protein Precursors/analysis
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/etiology/*metabolism/surgery
MH  - Ventricular Remodeling/physiology
EDAT- 2007/02/27 09:00
MHDA- 2007/07/20 09:00
CRDT- 2007/02/27 09:00
PHST- 2006/11/17 00:00 [received]
PHST- 2007/01/21 00:00 [revised]
PHST- 2007/01/23 00:00 [accepted]
PHST- 2007/02/27 09:00 [pubmed]
PHST- 2007/07/20 09:00 [medline]
PHST- 2007/02/27 09:00 [entrez]
AID - S1010-7940(07)00120-0 [pii]
AID - 10.1016/j.ejcts.2007.01.038 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2007 May;31(5):922-8. doi: 10.1016/j.ejcts.2007.01.038. 
      Epub 2007 Feb 23.