|Jain D et al.|
Early Post-Operative Haemodynamic and Neurohumoral Follow-Up After Endoaneurysmorrhaphy
Journal of Clinical and Basic Cardiology 2001; 4 (2): 165-167
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Keywords: Aneurysma, Hormon, Hämodynamik, Myokardinfarkt, Revaskularisation, aneurysm, haemodynamic, hormone, myocardial infarction, revascularisation
Results of endoaneurysmorrhaphy (EAR) have been followed haemodynamically and functionally. Since heart failure and myocardial infarctions with left ventricular (LV) dysfunction are associated with prognostically significant neurohumoral activation, we sought to study patients undergoing EAR haemodynamically and neurohumorally in the early post-operative period. Arterial plasma levels of N-terminal pro-atrial natriuretic peptide (Nt-proANP), N-terminal pro-brain natriuretic peptide, arginine vasopressin (AVP), endothelin, norepinephrine and epinephrine were measured before and early postoperatively (day 6-21, median 8.5) in 11 patients undergoing EAR. Pre- and postoperative haemodynamic and angiographic examination was carried out in all patients. Ejection fraction improved from 31.7 ± 4.3 to 48.2 ± 4.4 % (p < 0.005) after surgery. Left ventricular end-diastolic pressure (LVEDP) increased significantly from 11.3 ± 2.4 to 19.1 ± 3.5 mmHg (p < 0.05). The Nt-proANP levels also increased significantly from 1121 ± 219 to 1921 ± 190 fmol/ml (p < 0.005). Postoperatively, LVEDP showed a positive correlation with plasma Nt-proANP (r = 0.73, p = 0.01). There appears to be a discordance in LV pump functions early postoperatively. An improvement in systolic performance is accompanied by a worsening of diastolic function. This is further substantiated by an increase in Nt-proANP, a bad prognostic marker. The results are, however, preliminary.