Role of B-Type Natriuretic Peptide and Effect of Nesiritide After Total Cardiac Replacement With the AbioCor Total Artificial Heart

• Published in: The Journal of heart and lung transplantation Vol. 24; no. 8; pp. 1166 - 1170
• Main Authors: Delgado, Reynolds, Wadia, Yasmin, Kar, Biswajit, Ethridge, Whitson, Zewail, Aly, Pool, Toni, Myers, Timothy J., Scroggins, Nancy, Frazier, O.H.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2005; Elsevier Science
• Subjects: Acute Kidney Injury - diagnosis; Acute Kidney Injury - drug therapy; Aged; Biological and medical sciences; Biomarkers - analysis; Dose-Response Relationship, Drug; Drug Administration Schedule; Follow-Up Studies; Heart Failure - diagnosis; Heart Failure - surgery; Heart, Artificial - adverse effects; Humans; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Natriuretic Peptide, Brain - administration & dosage; Natriuretic Peptides - analysis; Natriuretic Peptides - metabolism; Risk Assessment; Sampling Studies; Severity of Illness Index; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Treatment Outcome; Artificial heart; Brain natriuretic peptide; Treatment; Respiratory disease; Surgery; Nesiritide; Total; Cardiovascular disease; Replacement
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2004.10.008

Endogenous B-type natriuretic peptide (BNP) is thought to be produced in the cardiac ventricles. After sub-total cardiectomy and implantation of a total artificial heart (TAH), the abrupt withdrawal of BNP impairs renal function despite normal hemodynamic variables. We hypothesized that abrupt withdrawal of endogenous BNP may impair renal function and volume homeostasis and BNP may have a direct renal influence unrelated to its cardiovascular effect. Nesiritide infusion should be supplemented in the interim and weaned slowly until BNP levels normalize, which suggests that BNP is produced in tissues other than the cardiac ventricles.