The Atrial Natriuretic Peptide and Its Relation to Hemodynamic and Laboratory Values in Mitral Valve and Coronary Surgery

Abstract

In 22 patients who underwent mitral valve replacement (13) or coronary bypass surgery (9), preoperative and postoperative plasma atrial natriuretic peptide (p-ANP) concentration, hemodynamic changes, plasma aldosterone, and twenty-four-hour urine sodium-potassium concentrations were studied. Preoperative ANP levels were 261±172 pg/mL in mitral valve replacement (MVR) and 68±22 in coronary artery bypass grafting (CABG); control levels were 15±4.7 (p < 0.001). After the induction of anesthesia, ANP levels decreased to 154.5±96.7 pg/mL in MVR and 51±17.5 in CABG (p < 0.01) patients. In the early postop erative period ANP increased to 332±217 pg/mL in MVR and to 94.3 ± 29.7 in CABG (p < 0.001). In the late postoperative period, the p-ANP of both groups returned to nor mal levels (16 ± 8.05, 11.2 ± 2.82 pg/mL, respectively). Negative correlations were detected in both MVR and CABG groups be tween p-ANP, p-aldosterone (p < 0.001), p—ANP—cardiac output (p < 0.001), and p—ANP—cardiac index (p < 0.001).