Background:
N-terminal pro-brain natriuretic peptide (nt-probnp) is an important biomarker to indicate cardiac function, but its significance in cardiac surgery is still unclear.
Objective:
To explore clinical significance of serum nt-probnp and their dynamic characteristics in patients with cardiac valve replacement (cvr).
Methods:
Dynamically detecting pre-operative and postoperative serum nt-probnp on elecsys 2010 in 60 cvr patients.
Results:
(1) there was a good relationship between pre-operative nt-probnp and pre-operative nyha classification, ejection fraction, fractional shortening, or between postoperative 1 day log [nt-probnp] and postoperative icu time, correlation coefficients were respectively 0.426 (p=0.001), -0.465 (p=0.001), -0.463 (p=0.002), and 0.453 (p=0.006). (2) pre-operative nt-probnp would be higher in multivalves damage or mitral lesions patients than that in single valve damage or aortic lesions. it indicated nt-probnp>1,352βpg/ml could discriminate multivalves damage in rheumatic heart diseases (rhd) patients (sensitivity: 0.742; specificity: 0.64); and nt-probnp>549.12βpg/ml could differentiate mitral lesions and aortic lesions (sensitivity: 0.92; specificity: 0.75). however, pre-operative serum nt-probnp for differentiating atrial fibrillation and sinus arrhythmia was not most efficient (auc=0.655; p=0.044). (3) perioperative nt-probnp in cvr patients was characterized by early postoperative nt-probnp increasing and late postoperative nt-probnp decreasing. the peak of postoperation nt-probnp was at postoperative 7 days.
Conclusions:
Serum nt-probnp was not only a good biomarker to effectively evaluate heart function but also to evaluate the cardiac valve damage in rhd patients, and postoperative nt-probnp dynamic determination, especially detecting postoperative 1 day, 7 days and 14 days nt-probnp would be more useful to evaluate prognosis of cvr patients.