Sage Journals: Discover world-class research

Abstract

Objective: To determine preoperative ventricular function in vascular amputees by measuring N-terminal pro-brain natriuretic peptide (NT-proBNP) and to analyse the relationship between NT-proBNP levels and 30-day postoperative mortality. Design: Prospective pilot study.

Subjects and methods: In 19 patients planned for a lower limb amputation for non-reconstructable peripheral arterial disease NT-proBNP was measured the day before amputation.

Results: Four amputees died within 30 days after the amputation. In 17 of 19 patients NT-proBNP values were found more than 2 standard deviations above the age corrected reference value. Pre-amputation NT-proBNP levels did not differ significantly between non-survivors and survivors (P = 0.162).

Conclusion: Preoperative NT-proBNP levels are not significantly related to 30-day mortality after lower limb amputation procedure. Preoperative NT-proBNP levels are very high, indicating that serious ventricular dysfunction may be present in vascular amputees.

Get full access to this article

View all access options for this article.

References

Cruz CP , Eidt JF , Capps C. , Kirtley L. , Moursi MM Major lower extremity amputations at a Veterans Affairs hospital. Am J Surg 2003; 186: 449—54.

Aulivola B. , Hile CN , Hamdan AD et al. Major lower extremity amputation — outcome of a modern series. Arch Surg 2004; 139: 395—99.

Jaegers SMHJ , Vos LDW , Rispens P. , Hof AL The relationship between comfortable and most metabolically efficient walking speed in persons with unilateral above-knee amputation. Arch Phys Med Rehabil 1993; 74: 521—25.

Gailey RS , Wenger MA , Raya M. et al. Energyexpenditure of trans-tibial amputees during ambulation at self-selected pace. Prosthet Orthot Int 1994 ; 18: 84—91.

Czerniecki JM Rehabilitation in limb deficiency.1. Gait and motion analysis. Arch Phys Med Rehabil 1996 ; 77: S3—S8.

McDonagh TA , Robb SD , Murdoch DR et al. Biochemical detection of left-ventricular systolic dysfunction . Lancet 1998; 351: 9—13.

Tulevski II , Groenink M. , van der Wall EE et al. Increased brain and atrial natriuretic peptides in patients with chronic right ventricular pressure overload: correlation between plasma neurohormones and right ventricular dysfunction. Heart 2001; 86: 27—30.

Fisher C. , Berry C. , Blue L. , Morton JJ , Hillier C. , McMurray JJ N terminal B-type natriuretic peptide, but not the FP437 putative cardiac hormone relaxin, predicts adverse outcome in patients with chronic heart failure . Eur Heart J 2003; 24: 61.

James SK , Lindahl B. , Siegbahn A. et al. N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality andsubsequent myocardial infarction in patients with unstable coronary artery disease — a Global Utilization of Strategies to Open occluded arteries (GUSTO)-IV substudy. Circulation 2003; 108: 275—81.

10.

Umachandran V. , Ranjadayalan K. , Ambepityia G. , Marchant B. , Kopelman PG , Timmis AD The Perception of angina in diabetes — relation to somatic pain threshold and autonomic function. Am Heart J 1991; 121: 1649—54.

11.

Bruins S. , Fokkema MR , Romer JWP et al. High intraindividual variation of B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with stable chronic heart failure . Clin Chem 2004; 50: 2052—58.

Mortality and preoperative cardiac function in vascular amputees: an N-terminal pro-brain natriuretic peptide (NT-proBNP) pilot study

Abstract

Get full access to this article

References