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.

journal_name

J Clin Lab Anal

authors

Cai B,Wang L,Liu J,Shi Y,Guo Y

doi

10.1002/jcla.20435

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

149-55

issue

3

eissn

0887-8013

issn

1098-2825

journal_volume

25

pub_type

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