Low-dose continuous infusion of human atrial natriuretic peptide during and after cardiac surgery

Sezai, Akira; Shiono, Motomi; Orime, Yukihiko; Hata, Hiroyuki; Hata, Mitsumasa; Negishi, Nanao; Sezai, Yukiyasu

doi:10.1016/s0003-4975(99)01305-3

Cited by 88 publications

(83 citation statements)

References 13 publications

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“…Because hANP inhibits the renin-angiotensin-aldsterone system and has a potent natriuretic effect, we have found that it can compensate for the adverse effects of cardiopulmonary bypass and can inhibit reperfusion injury, left ventricular remodeling, postoperative arrhythmia and renal dysfunction. [11][12][13][14][15][16] In an experiment study, cyclic guanosine monophosphate was increased by the administration of hANP, and myocardial protective effects were reported. 17,18) Recently, continuous intravenous administration of hANP or BNP have been performed in cardiac surgery worldwide, its cardiac and reno-protective effects have been reported.…”

Section: Discussionmentioning

confidence: 99%

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Sezai¹,

Hata²,

Yoshitake³

et al. 2012

Ann Thorac Cardiovasc Surg

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Background: The results of emergency coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) are less than satisfactory, and readmission for cardiac events is common. Methods and Results: 105 patients underwent emergency CABG for AMI. We examined the long-term results of emergency CABG for AMI from the viewpoints of preoperative, intraoperative, and postoperative factors. The operative mortality rate was 11.4%. Risk factors for early death were age ≥80 years, shock, veno-arterial bypass, creatine kinase isoenzyme Mb ≥100 U/L, non-use of a left internal thoracic artery graft and an extracorporeal circulation time ≥120 min. Risk factors for late cardiac events were ejection fraction <40%, non-use of human atrial natriuretic peptide (hANP) therapy, angiotensin II receptor blockers (ARB) and aldosterone blockers, and a 3-month postoperative brain natriuretic peptide level ≥200 pg/ml. Conclusions: Early results of this study are similar to those seen in previous reports, whereas late phase results yield some new and interesting findings. We suggest that intraoperative hANP, and postoperative aldosterone blocker and ARB, following CABG for AMI, will, through control of the renin-angiotensin-aldsterone system, inhibit left ventricular remodelling, reduce the extent of infarction, and improve cardiac function, yielding a favourable long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Sezai¹,

Hata²,

Yoshitake³

et al. 2012

Ann Thorac Cardiovasc Surg

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“…Sezai, et al reported that carperitide acted to reverse these changes in every aspect. [13][14][15][16][17][18] They administered the drug at 0.02 µg/kg/min from the start of CPB, after taking into consideration that their patients did not have heart failure before surgery and might become dehydrated as a result of fasting for one day prior to the operation. Their findings showed inhibition of the renin-angiotensin-aldosterone system and less fluid retention in the third space due to a strong diuretic action.…”

Section: Discussionmentioning

confidence: 99%

“…13) In addition, it has been reported that ANP decreases the demand for furosemide, inhibits potassium loss, reduces electrolyte imbalance, and prevents arrhythmia development during unstable conditions after surgery. [14][15][16][17][18] Thus, it has become a useful drug for perioperative and postoperative management of patients treated in our department.…”

Section: Effects Of Continuous Infusion Of Low-dose Human Atrial Natrmentioning

confidence: 99%

Effects of Continuous Infusion of Low-dose Human Atrial Natriuretic Peptide (hANP) on the Lungs during Cardiac Surgery

Shibasaki

Fukuda

Yamada

et al. 2015

ATCS

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Objective: The objective of this study was to determine the effects of a continuous infusion of low-dose hANP on the lungs during cardiac surgery in patients under cardiopulmonary bypass (CPB). Methods: We analyzed 30 consecutive cases of cardiac surgery performed at our hospital from 2007-2008. The patients were divided into a group that received hANP (hANP group) or a group that received saline and no hANP (N-hANP group). We measured various parameters before and after surgery using a PiCCO monitor. Result: There were no differences in the preoperative characteristics between the groups, although urine volume during the operation was significantly greater in the hANP group. After surgery, there were no significant differences between the groups in cardiac output index (CI), global enddiastolic volume index (GEDVI), intrathoracic blood volume index (ITBI), pulmonary blood volume index (PBI), extravascular lung water index (ELWI) and pulmonary vascular permeability index (PVPI), total protein, and creatine. In contrast, interleukin-6 (IL-6) and renin were significantly lower, and albumin was significantly higher in the hANP group. Conclusion: We found that low-dose hANP during open cardiac surgery inhibited the secretion and plasma activity of IL-6 and renin. Although there were no differences in lung circulatory parameters such as the amount of fluid in the pulmonary blood vessels between the two groups, we believe that the strong diuretic effect of hANP reduced third-space fluid retention caused by CPB.

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“…We considered that hANP could be useful in this pathological situation, and we have shown that continuous infusion of low-dose hANP from the start of CPB suppresses left ventricular remodeling by blocking the RAAS and promoting natriuresis. [14][15][16] hANP is usually administered for heart failure through continuous infusion at a starting dose of 0.05 to 0.1 μg/ kg/min or through bolus injection. Because of our knowledge about past studies, we also suggested that efficacy of low dose hANP was obtained at a dose of only 0.02 μg/ kg/min without the problems of hypotension and rebound associated with hANP administration.…”

Section: )mentioning

confidence: 99%

“…Because of our knowledge about past studies, we also suggested that efficacy of low dose hANP was obtained at a dose of only 0.02 μg/ kg/min without the problems of hypotension and rebound associated with hANP administration. 14,15) In this study, we hypothesized that the administration of hANP during CABG would be beneficial for CKD due to RAAS inhibition and it would be tends to prevent the renal function, and we investigated the effect of hANP by retrospective analysis.…”

Section: )mentioning

confidence: 99%

Low-dose Atrial Natriuretic Peptide for Chronic Kidney Disease in Coronary Surgery

Yoshitake

Sezai

Hata

et al. 2011

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Low-dose continuous infusion of human atrial natriuretic peptide during and after cardiac surgery

Cited by 88 publications

References 13 publications

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Results of Emergency Coronary Artery Bypass Grafting for Acute Myocardial Infarction: Importance of Intraoperative and Postoperative Cardiac Medical Therapy

Effects of Continuous Infusion of Low-dose Human Atrial Natriuretic Peptide (hANP) on the Lungs during Cardiac Surgery

Low-dose Atrial Natriuretic Peptide for Chronic Kidney Disease in Coronary Surgery

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