Aminoterminal proBrain Natriuretic Peptide en sangre como marcador de isquemia miocárdica en la evaluación de pacientes con dolor torácico y probabilidad intermedia para síndrome coronario agudo / Natriuretic peptide amino proBrain blood as a marker of myocardial ischemia in the evaluation of patients with chest pain and intermediate risk for acute coronary syndrome

Introducción: lo péptidos natruréticos son una familia de hormonas polipeptídicas sistetizadas, acumuladas en gránulos de reserva y secretadas por los cardiocitos auriculares y ventriculares; ellas regulan el tono vascular y mecanismos renales y metabólicos. Aminoterminal proBrain Natriuretic Peptide (NT.proBNP), es un fragmento inactivo que resulta del clivaje del proBrain Natriuretic Peptide y es un biomarcador de disfunción cardíaca. Los niveles plasmáticos de los péptidos natriuréticos pueden elevarse ante estímulos diversos como insuficiencia cardíaca, isquemia o inflamción. En los síndromes coronarios agudos son marcadores de riesgo y permiten una adecuada estratificación. Hipótesis: los niveles plasmáticos de NT-proBNP medidos antes de una prueba de esfuerzo en pacientes con probabilidad intermedia de síndrome coronario agudo, e inmediatamente después de maximo esfuerzo, detectarán isquemia miocárdica y predecirán eventos cardiovasculares a 30 días y 6 meses.

Introduction: natriuretic peptides are a family of polypeptide hormones synthesized, stored and secreted by atrial and ventricular cardiocytes; they regulate the vascular tone, and renal and metabolic mechanisms. Aminoterminal proBrain Natriuretic Peptide (NT-proBNP) is an inactive fragment thas is cleaved from the proBrain Natriuretic Peptide and it is a biomarker of different stimuli sch as heart failure, ischemia or inflammation. In acute coronary syndromes they are risk markers enabling adequate risk stratification. Hypothesis: plasma levels of NT-proBNP measured before a stress test in patients with an intermediate probability of acute coronary syndrome, and immediately after maximum stress will detect myocardial ischemia and will predict cardiovascular events at 30 days and 6 months.

Determination of atrial natriuretic factor during and after cardiopulmonary bypass

Atrial natriuretic factor [ANF] has natriuretic, diuretic and vasorelaxant properties and is elevated in patients with heart failure. Patients undergoing cardiopulmonary bypass [CPB] either for valves replacement or for congenital heart repair manifest complex derangement. The effect of CPB on ANF release in 10 patients [6 patients had valves replacement and 4 patients had congenital heart repair] was studied. During CPB, ANF in patients with valves replacement showed decreased value while patients with congenital heart repair demonstrated increased values as compared with the preoperative one. Forty-eight hours postoperatively, ANF values resumed back the base line in the valvular group, while it depassed the base line in the congenital group. Secretion of ANF has a complex mechanism and it needs further investigation for better management of patients postoperatively with hypertension after CPB