AUGMENTED RELEASE OF BRAIN NATRIURETIC PEPTIDE DURING REPERFUSION OF THE HUMAN HEART AFTER CARDIOPLEGIC CARDIAC-ARREST

The aim of the study was to investigate the release of natriuretic pep tides during myocardial ischaemia and reperfusion associated with card ioplegic cardiac arrest. Brain natriuretic peptide (BNP) and atrial na triuretic peptide (ANP) concentrations were measured in paired arteria l, central venous and coronary sinus blood samples in 19 patients unde rgoing elective coronary artery bypass grafting before aortic crosscla mping and 1, 5, 10 and 20 min after aortic declamping. Peak myocardial BNP release after aortic declamping was significantly higher than bas eline values before aortic crossclamping. Both peak and cumulative BNP release during reperfusion correlated significantly with the severity of ischaemia, as assessed by myocardial lactate production. In 3 pati ents with perioperative myocardial ischaemia, cumulative and peak myoc ardial BNP release after aortic unclamping was markedly higher than in the remaining 16 uneventful patients, Myocardial ANP release during r eperfusion was not significantly different from baseline values before aortic crossclamping. In conclusion, our data demonstrate a significa ntly enhanced myocardial BNP release early during reperfusion of the h uman heart after global ischaemia associated with cardioplegic cardiac arrest. (C) 1997 Elsevier Science B.V.