Bredin Fredrik, Liska Jan, Franco-Cereceda Anders
Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Interact Cardiovasc Thorac Surg. 2009 Feb;8(2):191-4. doi: 10.1510/icvts.2008.186296. Epub 2008 Nov 13.
To evaluate the influence on circulating plasma levels of natriuretic peptides following passive containment surgery in heart failure patients with dilated cardiomyopathy, thirteen patients with dilated cardiomyopathy subjected to cardiac surgery received the Acorn Cardiac Support Device. Patients with ischemic cardiomyopathy (n=7) underwent coronary artery bypass surgery receiving 2-3 bypass grafts. In the idiopathic cardiomyopathy group (n=6), mitral valve plasty was performed in five patients while one patients received the Cardiac Support Device only. Circulating plasma atrial natriuretic peptide, brain natriuretic peptide and C-type natriuretic peptide were measured in all patients before surgery and 12 months postoperatively. Following surgery there was a significant decrease in circulating plasma levels of brain natriuretic peptide (0.14+/-0.04 ng/ml vs. 0.06+/-0.03 ng/ml, P<0.05). No significant changes were seen in circulating plasma levels of atrial natriuretic peptide or C-type natriuretic peptide. NYHA functional class improved (2.7+/-0.1 vs. 1.8+/-0.2, P<0.001). The 6-min-walk increased (354+/-35 m vs. 473+/-31 m, P<0.01). There was a decrease in left ventricular end diastolic diameter (73+/-2 mm vs. 65+/-2 mm, P<0.001) and left ventricular end systolic diameter (65+/-2 mm vs. 56+/-3 mm, P<0.01). Following passive containment surgery using the ACORN Cardiac Support Device functional improvement and reversed remodelling is accompanied by decreased BNP levels.
为评估被动性心脏包裹手术对扩张型心肌病心力衰竭患者循环血浆利钠肽水平的影响，13例接受心脏手术的扩张型心肌病患者植入了橡果心脏支持装置。7例缺血性心肌病患者接受了冠状动脉搭桥手术，搭桥2 - 3处。在特发性心肌病组（n = 6）中，5例患者进行了二尖瓣成形术，1例仅接受了心脏支持装置。所有患者在手术前及术后12个月均检测了循环血浆心房利钠肽、脑利钠肽和C型利钠肽。手术后，循环血浆脑利钠肽水平显著下降（0.14±0.04 ng/ml对0.06±0.03 ng/ml，P<0.05）。循环血浆心房利钠肽或C型利钠肽水平未见显著变化。纽约心脏协会（NYHA）心功能分级改善（2.7±0.1对1.8±0.2，P<0.001）。6分钟步行距离增加（354±35米对473±31米，P<0.01）。左心室舒张末期内径减小（73±2毫米对65±2毫米，P<0.001），左心室收缩末期内径减小（65±2毫米对56±3毫米，P<0.01）。使用橡果心脏支持装置进行被动性心脏包裹手术后，功能改善和逆向重塑伴随着脑利钠肽水平降低。
