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Titolo:
Atrial natriuretic peptide (ANP)-levels reveal mild postoperative myocardial dysfunction after uncomplicated coronary bypass surgery
Autore:
Langenbach, MR; Korbmacher, B; Schulte, H; Zirngibl, H; Grabensee, B; Plum, J;
Indirizzi:
Klinikum Barmen, Abt Viszeral & Allgemeinchirurg, D-42283 Wuppertal, Germany Klinikum Barmen Wuppertal Germany D-42283 rg, D-42283 Wuppertal, Germany Univ Dusseldorf, Abt Herz & Thoraxchirurg, D-40225 Dusseldorf, Germany Univ Dusseldorf Dusseldorf Germany D-40225 , D-40225 Dusseldorf, Germany Univ Dusseldorf, Inst Nephrol & Rheumatol, D-40225 Dusseldorf, Germany Univ Dusseldorf Dusseldorf Germany D-40225 , D-40225 Dusseldorf, Germany
Titolo Testata:
ZEITSCHRIFT FUR KARDIOLOGIE
fascicolo: 12, volume: 89, anno: 2000,
pagine: 1133 - 1140
SICI:
0300-5860(200012)89:12<1133:ANP(RM>2.0.ZU;2-D
Fonte:
ISI
Lingua:
GER
Soggetto:
VENTRICULAR SYSTOLIC DYSFUNCTION; CONGESTIVE HEART-FAILURE; CARDIAC TROPONIN-T; CARDIOPULMONARY BYPASS; ARTERY SURGERY; RELEASE; INFARCTION; ISCHEMIA; PERFORMANCE; INDICATORS;
Keywords:
ANP; troponin; coronary artery disease; myocardial injury; postischemic dysfunction;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Langenbach, MR Klinikum Barmen, Abt Viszeral & Allgemeinchirurg, Heusnerstr 40, D-42283 Wuppertal, Germany Klinikum Barmen Heusnerstr 40 Wuppertal Germany D-42283 ny
Citazione:
M.R. Langenbach et al., "Atrial natriuretic peptide (ANP)-levels reveal mild postoperative myocardial dysfunction after uncomplicated coronary bypass surgery", Z KARDIOL, 89(12), 2000, pp. 1133-1140

Abstract

Plasma levels of ANP (pg/ml; radioimmunassay) as a parameter for postischemic dysfunction and levels of Troponin T (TnT) (ng/ml; ELISA test) as a parameter for postischemic cellular damage were determined in 15 patients withcoronary artery disease (CAD) (mean age: 58+/-6.1 years; 13 m, 2 w; with no history of myocardial infarction and no signs for congestive heart failure) prior to, during and after extracorporal circulation (ECC). Under standardized conditions during the ECC basic parameters concerning the cardial hemodynamic (heart rate (HR); systolic (RRsys, mmHg), diastolic pressure (RR dia, mmHg) central venous pressure (CVP, mmHg); left atrial pressure (LAP, mmHg); left ventricular enddiastolic pressure (LVEDP, mmHg)) and ECG monitoring blood samples were performed: 1) prior to operation top):2) prior to CPB; 3) 1 h CPB; 4) 5 min after CPB; 5) 1 h after CPB; 6) 6 h postoperative (postop); 7) 24 h postop; 8) 48 h postop; 9) 10 days postop. Also the left atrial diameter (LAD, mm) and the left ventricular enddiastolic diameter at Q (LVEDD, mm) pre- and postop were documented with m-mode echocardiography (Echo) and ejection fraction (EF, %) was calculated. The bypass operations were performed with intermittent aortic crossclamping with open venae cavae (CVP: 0-5 mmHg) and moderate hypothermia. For the determination of ANP levels and TnT levels in atereal and venous blood, a double-antibody (AB) radioimmunassay and an ELISA test were used. Concerning the patients with CAD there was a maximal increase of ANP from preoperative 90 +/- 10 (M +/- SEM) pg/ml ( p<0.05) up to intraoperative 380+/- 38 pg/ml. Ten days postop, the ANP level was with 262 +/- 33 pg/ml still increased threefold in comparison to the preoperative level. TnT showed an increase from preoperative 0.02 +/- 0.01 ng/ml up to intraoperative 3.44+/- 0.47 ng/ml. Ten days postop the TnT concentration was at the preoperative level with 0.13 +/- 0.11 ng/ml. Five minutes after bypass up to 48 h postop, ANP and TnT levels were correlated (p<0.05, r = 3.4). There was an increase of the LAD from preoperative 42.2 +/- 1.1 mm up to 46.8 +/- 1.2 mm (p<0.05) 10 days postop as determined by m-mode echo. LVEDD and EF changed from preoperative 51.1 +/- 0.9 mm and 73 +/- 2% to 54.5 +/- 1.2 mm and 65 +/- 4% 10 days postop. The significant increase of TnT (172-fold) indicates the cellular, myocardial injury, caused by the operation without signs in ECG recordings and no signs of congestive heart failure. The significantly increased ANP level upto the 10th day postop indicate sa very sensitive prolonged, postischemic dysfunction, which is not compensated 10 days postop.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 08:57:36