Intensive Care Medicine

, Volume 33, Issue 6, pp 986–992

Combined measurements of N-terminal pro-brain natriuretic peptide and cardiac troponins in potential organ donors

  • Armelle Nicolas-Robin
  • Nadège Salvi
  • Sassi Medimagh
  • Julien Amour
  • Yannick Le Manach
  • Pierre Coriat
  • Bruno Riou
  • Olivier Langeron
Original

DOI: 10.1007/s00134-007-0601-7

Cite this article as:
Nicolas-Robin, A., Salvi, N., Medimagh, S. et al. Intensive Care Med (2007) 33: 986. doi:10.1007/s00134-007-0601-7

Abstract

Objective

Brain death may induce cardiac dysfunction. In potential organ donors measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) and circulating cardiac troponins T and I (cTnT and cTnI), alone or in combination, are performed to investigate the accuracy of these biomarkers for early diagnosis of left ventricular systolic dysfunction.

Design and setting

Prospective study in a multidisciplinary intensive care unit of an university hospital.

Patients

63 brain-dead patients scheduled for multiple organ harvesting.

Measurements and results

We measured NT-proBNP, cTnT, and cTnI and determined fractional area change (FAC) using transesophageal echocardiography. Forty-five patients had normal FAC, 9 a moderate decrease in FAC (30–50), and 9 a severe decrease in FAC (≤ 30%). NT-proBNP and cTnT concentrations were significantly higher in patients with a severe decrease in FAC than in those with a moderate decrease. Combining measurements of these two biomarkers, the sensitivity of the test to predict severe decrease in FAC increased significantly to reach 1.00 compared with the sensitivities of individual measurements. The ROC curve area of combined measurements of NT-proBNP and cTnT was significantly higher than single measurements: 0.87 vs. 0.82 for NT-proBNP, 0.78 for cTnT, and 0.72 for cTnI.

Conclusions

In potential organ donors the combined measurement of NT-proBNP and cTnT concentrations is more accurate than individual measurement of NT-proBNP, cTnT, and cTnI in the early diagnosis of severe left ventricular systolic dysfunction. These findings may lead to improve the quality of cardiac care of the potential organ donors.

Keywords

Pro-brain natriuretic peptideTroponinHeart failureBrain deathTransplantation

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Armelle Nicolas-Robin
    • 1
  • Nadège Salvi
    • 1
  • Sassi Medimagh
    • 2
  • Julien Amour
    • 1
  • Yannick Le Manach
    • 1
  • Pierre Coriat
    • 1
  • Bruno Riou
    • 3
  • Olivier Langeron
    • 1
  1. 1.Department of Anesthesiology and Critical CareCentre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParis Cédex 13France
  2. 2.Department of Emergency BiologyCentre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParisFrance
  3. 3.Department of Emergency Medicine and SurgeryCentre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParisFrance