The Perioperative Changes in and Clinical Value of B-type Natriuretic Peptide Levels in the Blood of Cardiosurgical Patients

Kozlov, I. A.; Буржунова, М. Г.; Чумаков, М. В.; Тимербаев, В. Х.

doi:10.15360/1813-9779-2012-4-133

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…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

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: 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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Overview of metabolomic markers used for diagnosing cardiovascular diseases

Astafyeva

Zharkov

Ясенявская

et al. 2022

Sibirskij nauchnyj medicinskij zhurnal

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At present, metabolomics is an intensively developing approach to the specific diagnosis of cardiovascular diseases. Metabolic analysis allows the study of complete metabolomic profiles and their deviations resulting from changes, for example, gene and RNA expression, protein activity, or environmental factors. Analysis of the metabolomic blood profile helps in solving a large number of scientific and clinical problems, one of which is the search for markers of diseases, in particular, cardiovascular diseases (CVD). Aim of the study was to investigate metabolomic markers used for the diagnosis of cardiovascular diseases on the basis of literature data. Material and methods. The literature data was analyzed for key words: cardiovascular diseases, metabolomics, metabolic profile, metabolomic markers in da- tabases PubMed, Scopus, Web of Science, CyberLeninka, PatentDB, Science Direct Open Access, eLibrary. Results. Analysis of literature data and patent search confirms the high importance of metabolomic markers in the diagnosis of CVD. In the patent literature, BNP/NT-proBNP is most common used as a metabolic marker of CVD (11.27 %). The use of CRP (8.99 %) and troponin (8.49 %) is also common. PICP (0.02 %), sVCAM-1 (0.09 %), stimulating growth factor ST-2 (0.12 %) and thrombomodulin (0.12 %) as metabolic markers of CVD. Conclusions. Against the backdrop of analytical methods, metabolomics is the most important diagnostic area. At the same time, it should be noted that by combining the results of the analysis of metabolic studies with others, for example, genomic and proteomic, one can get a complete picture of the pathogenesis of diseases, assess the risk of complications, and also determine the effectiveness of the treatment.

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B-type natriuretic peptide informativeness in myocardial revascularization with cardio-pulmonary bypass

Kozlov,

Krichevskiy,

Rybakov

2024

Vestn. anesteziol. reanimatol.

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The objective was to study the dynamics of B-type natriuretic peptide (BNP) and its relationship with hemodynamic parameters during on-pump coronary artery bypass grafting (CABG), and to evaluate the informativeness of the biomarker as a predictor of myocardial dysfunction.Materials and methods. The study involved 127 patients aged 59 [54–66.75] years with ischemic heart disease who underwent CABG. The BNP blood level was determined in the operating room at stages: I – before surgery (BNP1 ), II – at the end of surgery (BNP2 ). Hemodynamic parameters were analyzed at the same stages. Correlation analysis, logistic regression with the calculation of the odds ratio (OR) and 95% confidence interval (95% CI) and ROC analysis with the calculation of the area under the ROC curve (AUC) were used.Results. BNP1 blood level was 49 [25.6–91.6], BNP2 – 90 [47.8–140.2] pg/ml (p < 0.0001). BNP1 correlated with central venous pressure (CVP) at stage I (rho = 0.212; p = 0.017) and with pulmonary artery wedge pressure (PAWP) at stage II (rho = 0.204; p = 0.045). BNP2 correlated with PAWP at stage II (rho = 0.204; p = 0.045). BNP1 > 52.1 pg/ml was the predictor of ICU length of stay > 24 hours (OR 1.0290, 95% CI 1.0154– 1.0427, p < 0.0001, AUC 0.775), BNP1 > 71 pg/ml was the predictor of inotropic index > 5 c. u. (OR 1.0076, 95% CI 1.0015–1.0138, p = 0.014, AUC 0.705) and BNP1 > 90.8 pg/ml was the predictor of vasoactive inotropic index > 10 c. u. (OR 1.0070, 95% CI 1.0014–1.0126, p = 0.013, AUC 0.727). BNP2 > 67.5 pg/ml was the predictor of ICU length of stay > 24 hours (OR 1.0179, 95% CI 1.0073–1.0287, p < 0.0009, AUC 0.763), BNP2 > 94.3 pg/ml was the predictor of inotropic index > 5 c. u. (OR 1.0063, 95% CI 1.0010–1.0117, p = 0.020, AUC 0.713), BNP2 > 144 pg/ml was the predictor of intra-aortic balloon pumping (OR 1.0037, 95% CI 1 .0000–1.0074, p = 0.048, AUC 0.854), BNP2 > 159 pg/ml was the predictor of vasoactive inotropic index > 10 c. u. (OR 1.0072, 95% CI 1.0006–1.0139, p = 0.033, AUC 0.729) and BNP2 > 161 pg/ml was the predictor of early mortality in the ICU (OR 1.0040, 95% CI 1, 0000-1.0080, p = 0.049, AUC 0.845). Conclusion. In 78.7% of patients undergoing on-pump CABG, BNP blood level does not exceed the upper limit of normal; by the end of surgery, the biomarker level increases by 32.9 [17.7–62.0] pg/ml. Before and at the end of surgery, BNP values are weakly correlated with CVP and PAWP and do not correlate with other hemodynamic parameters. Before surgery, BNP blood level in the range of 52.1–90.8 pg/ml are predictors of ICU stay > 24 hours (AUC 0.775), inotropic scale > 5 (AUC 0.705) and vasoactive-inotropic scale > 10 c. u. (AUC 0.727). At the end of surgery, BNP > 67.5 pg/ml is associated with an ICU stay > 24 hours (AUC 0.763), and BNP > 90.4 pg/ml is associated with inotropic scale > 5 c. u. (AUC 0.713). The BNP, increased to 144.0–161.0 pg/ml, indicates severe myocardial dysfunction, including hemodynamic support with intra-aortic balloon pumping (AUC 0.854), vasoactive-inotropic scale > 10 c. u. (AUC 0.729) and the risk of early mortality in the ICU (AUC 0.845).

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The Perioperative Changes in and Clinical Value of B-type Natriuretic Peptide Levels in the Blood of Cardiosurgical Patients

Cited by 3 publications

References 8 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

Overview of metabolomic markers used for diagnosing cardiovascular diseases

B-type natriuretic peptide informativeness in myocardial revascularization with cardio-pulmonary bypass

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