Document Detail


Acute B-type natriuretic peptide response and early postoperative right ventricular physiology following tetralogy of Fallot's repair.
MedLine Citation:
PMID:  22685026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
B-type natriuretic peptide (BNP) response early after a tetralogy of Fallot's repair remains unclear. BNP was measured pre- and post-operatively (immediately, day 1) in 18 children undergoing corrective repair with concurrent echocardiography (pre-, post-op day 1) to assess right ventricular (RV) systolic dysfunction, restrictive physiology, wall motion and pulmonary regurgitation (PR). In the first 24 h postoperatively, BNP rose acutely in all patients (mean 34.9 vs 144.4 vs 716.9 pg/ml at pre-op, days 0 and 1; P < 0.001). Immediate postoperative BNP correlated with preoperative haematocrit (rho = 0.52, P = 0.03) and inversely with preoperative oxygen saturation (rho = -0.63, P = 0.007). All patients showed reduced RV systolic function and abnormal wall motion with at least moderate PR in six patients (33.3%) and restrictive physiology in four (24%). Subsequent BNP expression (post-op day 1) correlated with a low RV fractional area change (rho = -0.51, P = 0.04), high oxygen extraction ratio (rho = 0.56, P = 0.02) and high central venous pressure (rho = 0.79, P < 0.001). The LV function and wall motion remained preserved in all patients. The mechanism of BNP expression is likely to be multi-factorial in the presence of a complex postoperative RV physiology in tetralogy of Fallot. An acute BNP response in the early postoperative period reflects an important physiological role and may be used as an adjunct biomarker to assess the RV function.
Authors:
Edward W K Peng; Richard Spooner; David Young; Mark H D Danton
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-06-08
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-21     Completed Date:  2013-01-17     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  335-9     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Royal Hospital for Sick Children, Glasgow, UK.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Child, Preschool
Echocardiography, Doppler
Exercise Test
Female
Follow-Up Studies
Heart Ventricles / physiopathology*,  ultrasonography
Humans
Infant
Male
Myocardial Contraction
Natriuretic Peptide, Brain / blood*
Postoperative Period
Prognosis
Prospective Studies
Systole
Tetralogy of Fallot / blood*,  physiopathology,  surgery
Time Factors
Ventricular Function, Right / physiology*
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections

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