• Circ. J. · Nov 2006

    Randomized Controlled Trial

    Efficacy of low-dose continuous infusion of alpha-human atrial natriuretic peptide (hANP) during cardiac surgery: possibility of postoperative left ventricular remodeling effect.

    • Akira Sezai, Mitsumasa Hata, Shinji Wakui, Motomi Shiono, Nanao Negishi, Yuji Kasamaki, Satoshi Saito, Jitsu Kato, and Kazutomo Minami.
    • Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan. asezai@med.nihon-u.ac.jp
    • Circ. J. 2006 Nov 1;70(11):1426-31.

    BackgroundThe aim of the present study was to evaluate the efficacy of alpha-human atrial natriuretic peptide (hANP) in cardiac surgery under cardiopulmonary bypass (CPB).Methods And ResultsA prospective randomized study was conducted with 150 patients who underwent scheduled coronary artery bypass grafting to compare a group of patients receiving 0.02 microg x kg(-1) x min(-1) of hANP from the initiation of CPB with a group not receiving hANP. Hemodynamics, levels of atrial and brain natriuretic peptides (BNP), angiotensin-II and aldosterone, renin activity, and left ventricular (LV) function were examined. The hANP group showed significantly lower renin activity and lower levels of angiotensin-II and aldosterone during the early postoperative period, compared with the non-hANP group. The incidence of postoperative ventricular arrhythmia and the postoperative peak level of creatine kinase-MB were significantly lower in the hANP group. BNP at 1 month after surgery and measures of LV function were also significantly lower in the hANP group.ConclusionsLow-dose continuous infusion of hANP during cardiac surgery not only had a compensatory effect for the imperfections of CPB during the early postoperative period but also an inhibitory effect on postoperative LV remodeling and a reduction in ischemia/reperfusion injury. hANP should be part of the postoperative care for cardiac surgery.

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