Augmented release of brain natriuretic peptide during reperfusion of the human heart after cardioplegic cardiac arrest

The aim of the study was to investigate the release of natriuretic peptides during myocardial ischaemia and reperfusion associated with cardioplegic cardiac arrest. Brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) concentrations were measured in paired arterial, central venous an...

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Bibliographic Details
Published in:Clinica chimica acta 1997-05, Vol.261 (1), p.57-68
Main Authors: Mair, Peter, Mair, Johannes, Bleier, Jürgen, Hörmann, Christoph, Balogh, Doris, Puschendorf, Bernd
Format: Article
Language:English
Subjects:
Adult
Aged
Atrial Natriuretic Factor - blood
Atrial Natriuretic Factor - physiology
Atrial natriuretic peptide
Biomarkers - blood
Brain natriuretic peptide
Cardioplegia
Coronary Artery Bypass
Coronary artery bypass grafting
Extracorporeal Circulation - adverse effects
Female
Heart Arrest, Induced - adverse effects
Humans
Ischaemia
Lactic Acid - blood
Male
Middle Aged
Myocardial Ischemia - blood
Myocardial Ischemia - physiopathology
Myocardial Ischemia - surgery
Myocardial Reperfusion - adverse effects
Myocardium - metabolism
Natriuretic Peptide, Brain
Nerve Tissue Proteins - blood
Nerve Tissue Proteins - physiology
Reperfusion
Troponin - blood
Troponin T
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Summary:The aim of the study was to investigate the release of natriuretic peptides during myocardial ischaemia and reperfusion associated with cardioplegic cardiac arrest. Brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) concentrations were measured in paired arterial, central venous and coronary sinus blood samples in 19 patients undergoing elective coronary artery bypass grafting before aortic crossclamping and 1, 5, 10 and 20 min after aortic declamping. Peak myocardial BNP release after aortic declamping was significantly higher than baseline values before aortic crossclamping. Both peak and cumulative BNP release during reperfusion correlated significantly with the severity of ischaemia, as assessed by myocardial lactate production. In 3 patients with perioperative myocardial ischaemia, cumulative and peak myocardial BNP release after aortic unclamping was markedly higher than in the remaining 16 uneventful patients. Myocardial ANP release during reperfusion was not significantly different from baseline values before aortic crossclamping. In conclusion, our data demonstrate a significantly enhanced myocardial BNP release early during reperfusion of the human heart after flobal ischaemia associated with cardioplegic cardiac arrest.
ISSN:0009-8981
1873-3492
DOI:10.1016/S0009-8981(97)06518-2