Analysis On The Changes Of NT-proBNP Levels And Their Relations To Perioperative Multi-factors In Patients After Cardiac Valve Replacement

Objectives Our aim was to determine the perioperative changes ofNT-proBNP levels in patients undergoing cardiac valve replacement and ifthose levels were related to any of the baseline clinical characteristics ofpatients before surgery or any of the perioperative multi-factors.Methods Prospective study including 63 patients(age 38.2±6.5)undergoing cardiac valve replacement from March 2005 to January 2006.Preoperatory and postoperatory data were collected. NT-proBNP levels weremeasured before surgery, 4 hours, 18 hours,24 hours,2 days, 3 days, 5 daysand 7 days after surgery by ELISA.Results 1. NT-proBNP levels started increasing the next day aftersurgery and continued to increase until the third day when they started todecrease. NT-proBNP levels in the seventh day were still higher than thoseofpreoperatory (P＜0.01). 2. In spite of preoperative orpostoperative,NT-proBNP levels were higher in patients with preoperativeatrial fibrilation.3. Postoperative NT-proBNP levels were positivelycorrelated to both bypass and crossclamp time (r=0.273, P=0.030 andr=0.266, P=0.035). 4. Postoperative NT-proBNP levels and TT,CT inpatients undergoing two valves replacement were higher than that inpatients undergoing single valve replacement.5. Postoperative NT-proBNP levels were positively correlated to the number of hours that inotropes wereneeded after cardiac surgery (r=0.399, P<0.01).Conclusions NT-proBNP levels of patients with atrial fibrillationwere higher than those of patients with sinus rhythm and they increasesignificantly after cardiac surgery. It can reflect the perioperative changes ofcardiac function in patients undergoing cardiac valve replacement. As avaluable biomarker, NT-proBNP levels can evaluate the damage ofmyocardial. NT-proBNP levels may be a useful tool for the management ofinotropes in patients undergoing cardiac surgery.