Watanabe Masazumi, Egi Koso, Hasegawa Satoru, Tanaka Hiroyuki, Ohshima Hisanaga, Sakamoto Tohru, Sunamori Makoto
Department of Thoracic and Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Surg Today. 2003;33(9):671-3. doi: 10.1007/s00595-003-2580-9.
The aim of this study was to examine whether serial changes in endogenous levels of brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) were associated with clinical status after coronary artery bypass grafting (CABG).
Serial blood samples were collected from 14 patients preoperatively, 2, 5 and 8 h after cardiopulmonary bypass, then up to 7 days postoperatively. Follow-up was done 2 years later.
We found a significant increase from the preoperative values in ANP and BNP concentrations on postoperative days 1 and 3 (P < 0.001). The elevated BNP concentration correlated with the preoperative values (r2 = 0.824, P = 0.0005). Retrospectively, the BNP concentrations after surgery in the patients who suffered cardiac events within 2 years were significantly higher than those in the patients free of cardiac events (P = 0.0023).
The BNP concentration after CABG was found to be corrected with interim clinical status after surgery. Thus, it may be necessary for patients with a high postoperative BNP concentration to be closely monitored for coronary events.
本研究旨在探讨脑钠肽(BNP)和心房钠尿肽(ANP)内源性水平的系列变化是否与冠状动脉旁路移植术(CABG)后的临床状况相关。
从14例患者术前、体外循环后2、5和8小时,以及术后直至7天采集系列血样。2年后进行随访。
我们发现术后第1天和第3天,ANP和BNP浓度较术前值显著升高(P < 0.001)。升高的BNP浓度与术前值相关(r2 = 0.824,P = 0.0005)。回顾性分析,2年内发生心脏事件的患者术后BNP浓度显著高于无心脏事件的患者(P = 0.0023)。
发现CABG术后BNP浓度与术后中期临床状况相关。因此,对于术后BNP浓度高的患者,可能有必要密切监测冠状动脉事件。