Prognostic value of plasma N-terminal pro-B-type natriuretic peptide concentration in patients with normal and impaired left ventricular systolic function undergoing surgery for abdominal aortic aneurysm

INTRODUCTION Implantation of an aortic-bifemoral prosthesis is characterised by a high (> 5%) rate of perioperative cardiovascular events. The main aim of the study is to demonstrate the usefulness of the determination of NT-proBNP concentration as a method of risk stratification of left ventricular dysfunction in patients subjected to surgery for aortic-bifemoral prosthesis implantation. MATERIAL AND METHODS Forty consecutive patients were examined and subjected to aortic-bifemoral prosthesis implantation. The examined patients were divided into two groups: 1) with normal left ventricular systolic function and EF ≥ 58% (group I), 2) with left ventricular systolic dysfunction and EF < 58% (group II). RESULTS In group I the median EF before surgery was 69.5% and the concentration of NT-proBNP 141.5 pg/ml. On day 7 after surgery respective values were EF 65.5%, NT-proBNP 498.55 pg/ml. In group II the median EF before surgery was 54%, and NT-proBNP concentration 303.9 pg/ml. CONCLUSIONS The concentration of plasma NT-proBNP before surgery well correlated with left ventricular ejection fraction. The values of NT-proBNP > 303.9 pg/ml strongly correlated with increased risk of left ventricular systolic dysfunction after surgery and they seem to have high prognostic value for the occurrence of cardiovascular events in this group of patients. The determination of NT-proBNP level on day 7 after surgery strongly correlated with the decrease of left ventricular ejection fraction in patients after the prosthesis implantation. It is a valuable diagnostic and prognostic factor of circulatory system efficiency before making a decision to discontinue hospitalization.