Preoperative B-type natriuretic peptide levels are associated with outcome after total cavopulmonary connection (Fontan).
Preoperative B-type natriuretic peptide levels are associated with outcome after total cavopulmonary connection (Fontan).
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DOI：
10.1016/j.jtcvs.2013.08.009
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发表时间：
2014-07
影响因子：
6
通讯作者：
Fineman, Jeffrey R.
中科院分区：
文献类型：
--
作者：
Radman, Monique;Keller, Roberta L.;Oishi, Peter;Datar, Sanjeev A.;Wellnitz, Kari;Azakie, Anthony;Hanley, Frank;Char, Danton;Hsu, Jong-Hau;Amrinovin, Rambod;Adatia, Ian;Fineman, Jeffrey R.
确定术前B型利钠肽（BNP）水平与TCPC术后结局之间的关系。单心室心脏缺损的手术缓解需要一系列分期手术，以TCPC结束。虽然结果有所改善，但TCPC早期拆除的风险仍然不可预测。尽管进行了广泛的术前评估，但对不良术后结果的预测仍不准确。我们前瞻性招募了50名接受TCPC的患者。我们收集了术前临床数据、术前血浆BNP水平和术后结局，包括术后一年内不良结局的发生率（定义为死亡、TCPC拆除或需要心脏移植）。平均± SD年龄为4.7 ± 2.1岁。需要TCPC拆除和术后早期机械心脏支持的患者（n=3; 55（42，121））的中位（IQR）术前BNP水平高于结局良好的患者（n=47; 11（5，17））（p<0.05）。事实上，术前BNP ≥ 40 pg/mL与TCPC清除的需要高度相关（灵敏度= 100%，特异性= 93%; p<0.05），PPV为50%，NPV为100%。术前BNP水平越高，ICU住院时间越长，住院时间越长，低心排血量综合征的发生率越高（p<0.05）。术前BNP血液水平与TCPC和TCPC取下后早期对机械支持的需求唯一相关，因此除了标准术前评估外，还可提供重要信息。
To determine the association between preoperative B-type natriuretic peptide (BNP) levels and outcome following TCPC. Surgical palliation of univentricular cardiac defects requires a series of staged operations, ending in a TCPC. Although outcomes have improved, there remains an unpredictable risk of early TCPC takedown. The prediction of adverse postoperative outcomes is imprecise, despite an extensive preoperative evaluation. We prospectively enrolled 50 patients undergoing TCPC. We collected preoperative clinical data, preoperative plasma BNP levels, and postoperative outcomes including the incidence of an adverse outcome within one year of surgery (defined as death, TCPC takedown or the need for cardiac transplantation). Mean ± SD age was 4.7 ± 2.1 years. Median (IQR) preoperative BNP levels were higher in patients who required TCPC takedown and early postoperative mechanical cardiac support (n=3; 55 (42, 121)) compared with a good outcome (n=47; 11 (5,17)) (p<0.05). In fact, a preoperative BNP ≥ 40 pg/mL was highly associated with the need for TCPC take down (sensitivity = 100%, specificity = 93%; p<0.05), yielding a PPV of 50% and an NPV of 100%. Higher preoperative BNP levels were also associated with longer ICU length of stay, longer hospital length of stay and increased incidence of low cardiac output syndrome (p<0.05). Preoperative BNP blood levels are uniquely associated with the need for mechanical support early after TCPC and TCPC take down, and thus may provide important information in addition to the standard preoperative assessment.
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影响因子：
158.5
作者：
Maisel, AS;Krishnaswamy, P;McCullough, PA
通讯作者：
McCullough, PA
影响因子：
2.8
作者：
Lowenthal, Alexander;Camacho, Benjamin Villareal;Bernstein, Harold S.
通讯作者：
Bernstein, Harold S.
DOI：
10.1016/j.jtcvs.2007.10.040
发表时间：
2008-04-01
影响因子：
6
作者：
Hsu, Jong-Hau;Oishi, Peter E.;Fineman, Jeffrey R.
通讯作者：
Fineman, Jeffrey R.
DOI：
10.1016/j.jtcvs.2005.10.052
发表时间：
2006-03-01
影响因子：
6
作者：
Shih, CY;Sapru, A;Fineman, JR
通讯作者：
Fineman, JR
影响因子：
64.8
作者：
SUDOH, T;KANGAWA, K;MATSUO, H
通讯作者：
MATSUO, H