Level of perioperative B-type natriuretic peptide associates with heart function after on-pump coronary artery bypass graft surgery on a beating heart.

Baocai Wang,Zhenwei Ge,Bangtian Peng,Zhaoyun Cheng,Ziniu Zhao,Xiaoqiang Quan

doi:10.12669/pjms.312.6189

Abstract

Objective:To explore the relationship of the perioperative B-type natriuretic peptide (BNP) level with heart function among patients undergoing on-pump coronary artery bypass graft surgery on a beating heart.Methods:Total 90 patients expected to undergo coronary artery bypass graft surgery were selected and their left ventricular ejection fraction (LVEF) were examined before operation. Patients with LVEF greater than or equal to 50% were selected as the A group (n=46), and those less than 50% formed the B group (n=44). BNP levels of the patients were examined and its relationship with cardiac function was analyzed.Results:BNP levels of group A was lower than that in group B pre-and post-operatively (until 7 days after the surgery), the difference is statistically significant (p<0.05). Pearson analysis showed that the BNP level was negatively correlated with the LVEF (r = 0.767, p< 0.05). The area under the Roc curve is 0.865.Conclusion:BNP level was negatively correlated with the LVEF. Perioperative BNP level can be used as the prediction for heart function of patients with on-pump coronary artery bypass graft surgery on a beating heart.

Highlights

Coronary artery disease (CAD), which is often the leading cause of death worldwide, is common in elderly people, and the morbidity increases every year.[1,2] The patient who has CAD with left ventricular dysfunction, which occur in a high incidence, often has a poor prognosis, the clinical treatment are coronary artery bypass graft (CABG) and drugs.[3]
CABG is commonly used for treating the CAD, but approximately one half of the CAD patients accompany with acute myocardial infarction or left ventricular dysfunction, who is dangerous when undergoing the on-pump CABG surgery, but this risk can be avoided when instead of off-pump CABG surgery on a beating heart.[7,8]
On-pump CABG surgery is widely used at present, which can effectively reduce the incidence of postoperative complications, and may lead to myocardial instability in patient who has a low left ventricular function.[9]

Summary

Introduction

Coronary artery disease (CAD), which is often the leading cause of death worldwide, is common in elderly people, and the morbidity increases every year.[1,2] The patient who has CAD with left ventricular dysfunction, which occur in a high incidence, often has a poor prognosis, the clinical treatment are coronary artery bypass graft (CABG) and drugs.[3]. On-pump CABG surgery on a beating heart is the combination of on-pump surgery and the CABG on beating heart, with the blood flow stable and low cardiac load during surgery, is conducive to revascularization and suitable for patients with serious CAD.[10]

Methods

Results

Conclusion