Natriuretic Peptides in the Perioperative Management of Cardiac Surgery Patients

Authors

  • Nader Moazami
  • Mehmet C. Oz

DOI:

https://doi.org/10.1532/HSF98.20051115

Abstract

Both heart failure (HF) and cardiac surgery with cardiopulmonary bypass result in a release of neurohormones, with a variety of physiologic effects. Administration of exogenous B-type natriuretic peptide (BNP) has beneficial hemodynamic effects and reduces the level of several neurohormones in HF patients. BNP is currently being investigated in the perioperative management of cardiac surgery patients and may be especially beneficial for patients with ventricular dysfunction, pulmonary hypertension, or renal dysfunction. Using a neurohormonal approach to supportive therapy may enhance future strategies for patients undergoing cardiac surgery, especially those at greatest risk for complications.

References

Boerrigter G, Burnett JC, Jr. 2004. Recent advances in natriuretic peptides in congestive heart failure. Expert Opin Investig Drugs 13(6):643-52.nBond BR, Dorman BH, Clair MJ, et al. 2001. Endothelin-1 during and after cardiopulmonary bypass: association to graft sensitivity and postoperative recovery. J Thorac Cardiovasc Surg 122(2):358-64.nBrewster UC, Setaro JF, Perazella MA. 2003. The renin-angiotensin-aldosterone system: cardiorenal effects and implications for renal and cardiovascular disease states. Am J Med Sci 326(1):15-24.nBrunner-La Rocca HP, Kaye DM, Woods RL, et al. 2001. Effects of intravenous brain natriuretic peptide on regional sympathetic activity in patients with chronic heart failure as compared with healthy control subjects. J Am Coll Cardiol 37(5):1221-7.nBurger AJ, Aronson D. 2001. Activity of the neurohormonal system and its relationship to autonomic abnormalities in decompensated heart failure. J Card Fail 7(2):122-8.nBurger AJ, Horton DP, LeJemtel T, et al. 2002. Effect of nesiritide (B-type natriuretic peptide) and dobutamine on ventricular arrhythmias in the treatment of patients with acutely decompensated congestive heart failure: The PRECEDENT Study. Am Heart J 144(6):1102-8.nButler J, Emerman C, Peacock WF, et al. 2004. on behalf of the VMAC Study Investigators. The efficacy and safety of B-type natriuretic peptide (nesiritide) in patients with renal insufficiency and acutely decompensated congestive heart failure. Nephrol Dial Transplant 19(2):391-9.nCarlucci F, Tabucchi A, Biagioli B, et al. 2002. Cardiac surgery: myocardial energy balance, antioxidant status and endothelial function after ischemia-reperfusion. Biomed Pharmacother 56(10):483-91.nClavell AL, Stingo AJ, Aarhus LL, et al. 1993. Biological actions of brain natriuretic peptide in thoracic inferior vena caval constriction. Am J Physiol 265(6 Pt 2):R1416-R1422.nCohen G, Shirai T, Weisel RD, et al. 1998. Optimal myocardial preconditioning in a human model of ischemia and reperfusion. Circulation 98(suppl)(19):II-184-II-194.nColucci WS, Elkayam U, Horton DP, et al. 2000. for the Nesiritide Study Group. Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. N Engl J Med 343(4):246-53.nDe Wet CJ, Affleck DG, Jacobsohn E, et al. 2004. Inhaled prostacyclin is safe, effective, and affordable in patients with pulmonary hypertension, right heart dysfunction, and refractory hypoxemia after cardiothoracic surgery. J Thorac Cardiovasc Surg 127(4):1058-67.nDowning SW, Edmunds LH, Jr. 1992. Release of vasoactive substances during cardiopulmonary bypass. Ann Thorac Surg 54(6):1236-43.nEichhorn EJ, Bristow MR. 1996. Medical therapy can improve the biological properties of the chronically failing heart. A new era in the treatment of heart failure. Circulation 94(9):2285-96.nEntwistle JWC, III, McLoughlin DE, Baghelai K. 2004. Postoperative nesiritide use following high-risk mitral valve replacement. The Heart Surgery Forum 7(3):E189-E190.nFeldman DS, Ikonomidis JS, Uber WE, et al. 2004. Human B-natriuretic peptide improves hemodynamics and renal function in heart transplant patients immediately after surgery. J Card Fail 10(4):292-6.nFrazier OH, Delgado RM. 2003. Mechanical circulatory support for advanced heart failure: where does it stand in 2003? Circulation 108(25): 3064-8.nHobbs RE. 2003. Using BNP to diagnose, manage, and treat heart failure. Cleve Clin J Med 70(4):333-6.nHunt SA, Baker DW, Chin MH, et al. 2001. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). Circulation 104(24):2996-3007.nJensen KT, Carstens J, Pedersen EB. 1998. Effect of BNP on renal hemodynamics, tubular function and vasoactive hormones in humans. Am J Physiol 274(1 Pt 2):F63-F72.nJensen KT, Eiskjaer H, Carstens J, et al. 1999. Renal effects of brain natriuretic peptide in patients with congestive heart failure. Clin Sci (Lond) 96(1):5-15.nYasue H, Yoshimura M. 1996. Natriuretic peptides in the treatment of heart failure. J Card Fail 2(4 suppl):S277-S285.nYasue H, Yoshimura M, Sumida H, et al. 1994. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 90(1):195-203.nYoshimura M, Yasue H, Morita E, et al. 1991. Hemodynamic, renal, and hormonal responses to brain natriuretic peptide infusion in patients with congestive heart failure. Circulation 84(4):1581-8.nYoshimura M, Yasue H, Ogawa H. 2001. Pathophysiological significance and clinical application of ANP and BNP in patients with heart failure. Can J Physiol Pharmacol 79(8):730-5.nZhou HL, Fiscus RR. 1989. Brain natriuretic peptide (BNP) causes endothelium-independent relaxation and elevation of cyclic GMP in rat thoracic aorta. Neuropeptides 14(3):161-9.nZimmerman MA, Albright TN, Raeburn CD, et al. 2002. Vasopressin in cardiovascular patients: therapeutic implications. Expert Opin Pharma-cother 3(5):505-12.nKrämer BK, Schweda F, Riegger GAJ. 1999. Diuretic treatment and diuretic resistance in heart failure. Am J Med 106(1):90-6.nLiao Y, Takashima S, Asano Y, et al. 2003. Activation of adenosine A receptor attenuates cardiac hypertrophy and prevents heart failure in murine left ventricular pressure-overload model. Circ Res 93(8):759-66.nMangano CM, Diamondstone LS, Ramsay JG, et al. 1998. for the Multi-center Study of Perioperative Ischemia Research Group. Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. Ann Intern Med 128(3):194-203.nMichaels AD, Klein A, Madden JA, et al. 2003. Effects of intravenous nesiritide on human coronary vasomotor regulation and myocardial oxygen uptake. Circulation 107(21):2697-701.nMills RM, Hobbs RE, Young JB. 2002. "BNP" for heart failure: role of nesiritide in cardiovascular therapeutics. Congest Heart Fail 8(5):270-3.nMurad F. 1986. Cyclic guanosine monophosphate as a mediator of vasodilation. J Clin Invest 78(1):1-5.nNakagawa O, Ogawa Y, Itoh H, et al. 1995. Rapid transcriptional activation and early mRNA turnover of brain natriuretic peptide in cardiocyte hypertrophy. Evidence for brain natriuretic peptide as an "emergency" cardiac hormone against ventricular overload. J Clin Invest 96(3):1280-7.nAbraham WT, Lowes BD, Ferguson DA, et al. 1998. Systemic hemodynamic, neurohormonal, and renal effects of a steady-state infusion of human brain natriuretic peptide in patients with hemodynamically decompensated heart failure. J Card Fail 4(1):37-44.nAkabane S, Matsushima Y, Matsuo H, et al. 1991. Effects of brain natriuretic peptide on renin secretion in normal and hypertonic saline-infused kidney. Eur J Pharmacol 198(2-3):143-8.nAlbright TN, Zimmerman MA, Selzman CH. 2002. Vasopressin in the cardiac surgery intensive care unit. Am J Crit Care 11(4):326-30.nAmerican Heart Association, American Stroke Association. (2005). Heart Disease and Stroke Statistics--2005 Update. http://www.americanheart.org/downloadable/heart/1105390918119HDSStats2005Update.pdf. Accessed: January 13, 2005.nAronson D, Burger AJ. 2002. Intravenous nesiritide (human B-type natriuretic peptide) reduces plasma endothelin-1 levels in patients with decompensated congestive heart failure. Am J Cardiol 90(4):435-8.nAsimakopoulos G, Taylor KM. 1998. Effects of cardiopulmonary bypass on leukocyte and endothelial adhesion molecules. Ann Thorac Surg 66(6):2135-44.nPalazzuoli A, Carrera A, Calabria P, et al. 2004. Brain natriuretic peptide levels during cardiac reperfusion: comparison between percutaneous coronary angioplasty and aorto-coronaric bypass. Clin Chim Acta 342(1-2): 87-92.nPeacock WF, Emerman CL. 2003. Safety and efficacy of nesiritide in the treatment of decompensated heart failure in observation patients [abstract 1027-89]. J Am Coll Cardiol 41(suppl A)(6):336A.nPölönen P, Ruokonen E, Hippeläinen M, et al. 2000. A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg 90(5):1052-9.nProtter AA, Wallace AM, Ferraris VA, et al. 1996. Relaxant effect of human brain natriuretic peptide on human artery and vein tissue. Am J Hypertens 9(5):432-6.nPublication Committee for the VMAC Investigators. 2002. Intravenous nesiritide vs nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. JAMA 287(12):1531-40.nRadovancevic B, Vrtovec B, Yazdanbakhsh AP, et al. 2003. Perioperative use of nesiritide in heart failure patients undergoing implantation of left ventricular assist device [abstract 391]. J Heart Lung Transplant 22 (1 suppl)S201.nRose EA, Gelijns AC, Moskowitz AJ, et al. 2001. for the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med 345 (20):1435-43.nSamuels LE, Holmes EC, Lee L. 2004. Nesiritide as an adjunctive therapy in adult patients with heart failure undergoing high-risk cardiac surgery. J Thorac Cardiovasc Surg 128(4):627-9.nSanyal S, Rosero HO, Homel P, et al. 2005. Nesiritide improves refractory heart failure following cardiac surgery [abstract 1045-52]. J Am Coll Cardiol 45(suppl A)(3):353A.nSezai A, Shiono M, Orime Y, et al. 2000. Low-dose continuous infusion of human atrial natriuretic peptide during and after cardiac surgery. Ann Thorac Surg 69(3):732-8.nVatta MS, Presas MF, Bianciotti LG, et al. 1997. B and C types natriuretic peptides modify norepinephrine uptake and release in the rat adrenal medulla. Peptides 18(10):1483-9.nVerma S, Maitland A, Weisel RD, et al. 2002. Hyperglycemia exaggerates ischemia-reperfusion-induced cardiomyocyte injury: reversal with endothelin antagonism. J Thorac Cardiovasc Surg 123(6):1120-4.nVolpe M, Savoia C, De Paolis P, et al. 2002. The renin-angiotensin system as a risk factor and therapeutic target for cardiovascular and renal disease. J Am Soc Nephrol 13(suppl 3):S173-S178.nWitteles R, Matsuda K, Fowler M. Utility of prolonged B-type natriuretic peptide infusions in patients prior to heart transplantation [abstract 176]. Presented at the American Transplant Congress 2003; Washington, DC; June 1, 2003. Yamamoto K, Burnett JC, Jr. Redfield MM. 1997. Effect of endogenous natriuretic peptide system on ventricular and coronary function in failing heart. Am J Physiol 273(5 Pt 2):H2406-H2414.nYancy CW, Saltzberg MT, Berkowitz RL, et al. 2004. Safety and feasibility of using serial infusions of nesiritide for heart failure in an outpatient setting (from the FUSION I Trial). Am J Cardiol 94(5):595-601.n

Published

2005-05-05

How to Cite

Moazami, N., & Oz, M. C. (2005). Natriuretic Peptides in the Perioperative Management of Cardiac Surgery Patients. The Heart Surgery Forum, 8(3), E151-E157. https://doi.org/10.1532/HSF98.20051115

Issue

Section

Articles

Most read articles by the same author(s)

1 2 > >>