Perioperative serum brain natriuretic peptide and cardiac troponin in elective intracranial surgery

Francesco Ruggieri, Marco Gemma, Maria Rosa Calvi, Elisa Nicelli, Andrea Agarossi, Luigi Beretta

Research output: Contribution to journalArticle

Abstract

Background: There are some intracranial insults which are associated with cardiac abnormalities. Studies of these abnormalities have never been carried out in elective intracranial neurosurgery for the removal of brain tumors. Our prospective study aims at quantifying serum cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after elective intracranial neurosurgery for tumor resection in patients with no history of cardiac abnormality. Methods: Pre- and postoperative serum cTnT and NT-proBNP were measured in 108 patients submitted to elective major intracranial surgery for the removal of neoplastic lesions. We tested potentially predictive models for these biomarker serum levels. Results: cTnT was undetectable both before and after surgery. Median (IQR) basal NT-proBNP was 35 (18-69) pg/mL and 110 (51-191) pg/mL after surgery. In a multiple linear regression model, basal NT-proBNP was predicted by age, gender, BMI, and the presence of "mass effect" (midline shift or effaced perimesencephalic cisterns on preoperative CT scan) (whole model P <0.0001; R 2 = 0.3502; and Adjusted R 2 = 0.3247). Postoperative NT-proBNP increase was predicted by baseline NT-proBNP level (whole model P <0.0001; R 2 = 0.5106; and Adjusted R 2 = 0.5052). Conclusion: An intracranial mass effect is associated with higher NT-proBNP serum levels in patients with a brain neoplasm. Following elective intracranial surgery for brain tumor resection NT-proBNP values increase.

Original languageEnglish
Pages (from-to)395-400
Number of pages6
JournalNeurocritical Care
Volume17
Issue number3
DOIs
Publication statusPublished - Dec 2012

Keywords

  • Brain
  • Cardiac disease
  • Mass effect
  • Natriuretic peptide
  • Neurosurgery
  • Troponin T

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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