B-type brain natriuretic peptide dynamics in surgical treatment of cardiological patients

Estimation of brain natriuretic peptide (BNP) is gradually becoming a standard in heart failure diagnostics. Data from other sources [1, 2] and results of our own studies [3, 4] both confirm that BNP level has a very high prognostic value in the assessment of heart failure risk and fatal outcome after surgical correction of acquired and congenital heart disease. In our investigation we explored BNP levels before and after surgical treatment performed on 52 adult patients with valvular heart disease, dilatation and diminished left ventricular contractile function (LVDd >60 mm, LVEF ≤50%), average age 45.0±13.0 years, as well as on 41 children with tetralogy of Fallot, average age 2.0±0.9 years. The investigation proved that BNP level is characterized by reliable correlation with heart failure functional class. In the early postoperative period, initial BNP level correlated with the dose and duration of cardioactive support applied, as well as with the necessity for introduction of circulatory assist devices. The number of days spent in intensive care unit was also closely connected to the initial BNP level. Among deceased patients and patients with a postoperative period complicated by heart failure, BNP levels were considerably higher compared to other patients.