2013 Volume 27 Issue 5 Pages 569-574
Background. Pulmonary resection has an impact on the right ventricular function, because of an elevated right ventricular afterload caused by the loss of the lung vascular bed. We examined the relationship between the extent of pulmonary resection and serum concentration of natriuretic peptides, used as a marker of heart failure.
Methods. We retrospectively analyzed clinical charts and laboratory data, and compared the 63 patients' clinical and surgical data and the measurement of natriuretic peptides; human atrial natriuretic peptide, HANP; N terminal pro brain natriuretic peptide, NT-proBNP, according to the volume of pulmonary resection. The natriuretic peptides were measured before and 7 days after surgery. The elevation was calculated with the value 7 days after surgery divided by that before surgery.
Results. The HANP level elevated 2.1 times in a group of 25 patients with lobectomy, whereas it elevated 1.5 times in a group of 28 patients with sublobar resection and 1.2 times in a group of 10 patients with non-pulmonary resection (p=0.019). The NT-proBNP level elevated 3.9 times in a group of patients with lobectomy, whereas it elevated 2.8 times in patients with sublobar resection and 1.6 times in patients with non-pulmonary resection. The NT-proBNP level tends to be higher in patients whose surgery involve a greater volume of pulmonary resection (p=0.051).
Conclusions. The natriuretic peptide level elevated after lung resection, and the elevation correlated with the volume of lung resection. This is important to consider when we choose limited lung resection for patients with severe cardiac dysfunction.
