The Informative Value of N-Terminal Pro-type B Natriuretic Peptide in Cardiac Surgical Patients with Hypercreatininemia

Буржунова, Г.; Guseva, G N; Рыбаков, Array Ю.; Кричевский, А.; Козлов, А. Е.

doi:10.15360/1813-9779-2011-6-40

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Igor N. Tyurin 1, 2 , Sergey A. Rautbart 3,4 , Denis N. Protsenko 2 , Sergey N. Shurygin 5 , Igor A. [3][4][5][6]. Statistical analysis of these data was performed using correlation analysis, logistic regression and receiver operating characteristic analysis.…”

Section: N-terminal Pro-b-type Natriuretic Peptide Is a Biomarker Of mentioning

confidence: 99%

“…Натрийуретический пептид (НУП) В-типа (BNP) играет важную роль в регуляции кровообращения и служит чувствительным биомаркером степени напряжения миокарда [3][4][5]. В различных клинических ситуациях диагностически значимые уровни НУП В-типа и свойства его динамики могут существенно варьироваться в зависимости от особенностей патофизиологических процессов [5][6][7][8]. Опубликованы сообщения о диагностической и прогностической значимости увеличения содержания в крови BNP и неактивной части его предшественника (NT-proBNP) при сепсисе и септическом шоке [9][10][11].…”

Section: Introductionunclassified

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N-terminal pro-B-type natriuretic peptide is a biomarker of myocardial stress in abdominal sepsis and septic shock

Tyurin¹,

Раутбарт²,

Protsenko³

et al. 2020

PKiK

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Aim. To evaluate the dynamics and prognostic significance of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in patients with severe abdominal sepsis.Methods. We analysed survey data of 54 patients (28 men and 26 women) aged 64.5 years [56.25–78.00] with abdominal sepsis or septic shock. Disease severity scored according to the Acute Physiology and Chronic Health Evaluation II criteria was 16.3 ± 0.8 and according to the Sequential Organ Failure Assessment (SOFA) was 3 [3–6]. Statistical analysis of these data was performed using correlation analysis, logistic regression and receiver operating characteristic analysis.Results. Serum NT-proBNP level during the 1st week following admission to the intensive care unit (ICU) exceeded normal values, i.e. 2,570 [116.25–6,559.5] to 4,600 [1,680–18,200] pg/ml. At all disease stages, serum NT-proBNP level correlated with sepsis severity scores (SOFA), procalcitonin (PCT) levels, lactatemia, mean arterial pressure, heart rate and inotropic and vasoactive–inotropic scales (rho = 0.329–0.433; p < 0.02). On ICU days 3–4, serum NT-proBNP level of >5100 pg/ml was associated with increased risk of mortality [65.6%–88.2%; area under the curve (AUC) = 0.806; р < 0.0001]. Similarly, during this interval, elevated serum NT-proBNP level was associated with the use of inotropic drugs (OR = 1.0001, 95% CI = 1.000–1.0002, p < 0.0059). Notably, we found that 76.9%–79.0% of the patients with serum NT-proBNP level of >5250 pg/ml were receiving inotropic drugs including adrenaline, dopamine and dobutamine. We were unable to identify a specific association between serum NT-proBNP level and norepinephrine administration. On ICU days 7 and 8, among patients with serum NT-proBNP level of >3450 pg/ml, we observed a very close relationship between serum NT-proBNP level and PCT (sensitivity = 63.6%, specificity = 66.7%, AUC = 0.708; р = 0.0041).Conclusion. Serum NT-proBNP level is considerably elevated in patients with abdominal sepsis or septic shock. NT-proBNP level was associated with both traditional indicators of sepsis severity and indicators characterising the state of systemic circulation. Notably, serum NT-proBNP level correlates with cardiac failure and inotropic drug requirement. Although the mechanisms underlying the observed increases in serum NT-proBNP level remain unclear, the present findings indicate that this mediator is clearly a significant biomarker and predictor of adverse outcomes related to abdominal sepsis and septic shock. Received 22 January 2020. Revised 27 January 2020. Accepted 11 February 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and study design: I.N. Tyurin, D.N. Protsenko, I.A. Kozlov Data collection and analysis: I.N. Tyurin, S.A. Rautbart, S.N. Shurygin Statistical analysis: I.N. Tyurin, S.A. Rautbart Drafting the article: I.N. Tyurin, D.N. Protsenko, I.A. Kozlov, S.N. Shurygin Critical revision of the article: I.N. Tyurin, I.A. Kozlov Final approval of the version to be published: I.N. Tyurin, S.A. Rautbart, D.N. Protsenko, S.N. Shurygin, I.A. Kozlov

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Section: N-terminal Pro-b-type Natriuretic Peptide Is a Biomarker Of mentioning

confidence: 99%

Section: Introductionunclassified

N-terminal pro-B-type natriuretic peptide is a biomarker of myocardial stress in abdominal sepsis and septic shock

Tyurin¹,

Раутбарт²,

Protsenko³

et al. 2020

PKiK

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The level of Brain natriuretic Peptide as a Predictor of the Postoperative Period at Operations with Artificial Blood circulation

Bakhareva

Надирадзе

Muravskaya

2019

Acta biomedica scientifica

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The level of natriuretic peptide is regarded as a prognostic predictor of postoperative heart failure in modern cardiac surgery, and moreover, this hormone is included in the standards of its early diagnosis around the world. This study was conducted at the Irkutsk Cardiac Surgery Center. The results of treatment of 78 patients were analyzed in order to determine the relationship between the dynamics of brain natriuretic peptides and the course of the early postoperative period in operations with artificial cardiopulmonary bypass. Patients were divided into three groups according to the level of natriuretic peptide elevation in the postoperative period. The study proved the dependence of the postoperative period on the multiplicity of the increase in the level of natriuretic peptide B-type.It was found that the higher the rate of increase in the hormone, the lower the numbers of the cardiac index in the postoperative period, longer duration of inotropic support (p > 0.05) and higher doses of adrenomimetics (p > 0.05). The duration of mechanical ventilation was also longer in the groups where a high level of natriuretic peptide was recorded (p > 0.05). Thus, the multiplicity of natriuretic peptide elevation can be a prognostic criterion for the postoperative period in cardiac patients. It is important to note that a single determination of the level of natriuretic peptide should not be used as a marker of postoperative heart failure and this study confirmed the necessity to monitor the dynamics of brain natriuretic peptide’s level in the perioperative period in patients operated with extracorporeal cardiopulmonary bypass.

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The Informative Value of N-Terminal Pro-type B Natriuretic Peptide in Cardiac Surgical Patients with Hypercreatininemia

Cited by 2 publications

References 9 publications

N-terminal pro-B-type natriuretic peptide is a biomarker of myocardial stress in abdominal sepsis and septic shock

N-terminal pro-B-type natriuretic peptide is a biomarker of myocardial stress in abdominal sepsis and septic shock

The level of Brain natriuretic Peptide as a Predictor of the Postoperative Period at Operations with Artificial Blood circulation

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