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Perioperative Serum Brain Natriuretic Peptide and Cardiac Troponin in Elective Intracranial Surgery

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Abstract

Background

There are some intracranial insults which are associated with cardiac abnormalities. Studies of these abnormalities have never been carried out in elective intracranial neurosurgery for the removal of brain tumors. Our prospective study aims at quantifying serum cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after elective intracranial neurosurgery for tumor resection in patients with no history of cardiac abnormality.

Methods

Pre- and postoperative serum cTnT and NT-proBNP were measured in 108 patients submitted to elective major intracranial surgery for the removal of neoplastic lesions. We tested potentially predictive models for these biomarker serum levels.

Results

cTnT was undetectable both before and after surgery. Median (IQR) basal NT-proBNP was 35 (18–69) pg/mL and 110 (51–191) pg/mL after surgery. In a multiple linear regression model, basal NT-proBNP was predicted by age, gender, BMI, and the presence of “mass effect” (midline shift or effaced perimesencephalic cisterns on preoperative CT scan) (whole model P < 0.0001; R 2 = 0.3502; and Adjusted R 2 = 0.3247). Postoperative NT-proBNP increase was predicted by baseline NT-proBNP level (whole model P < 0.0001; R 2 = 0.5106; and Adjusted R 2 = 0.5052).

Conclusion

An intracranial mass effect is associated with higher NT-proBNP serum levels in patients with a brain neoplasm. Following elective intracranial surgery for brain tumor resection NT-proBNP values increase.

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Acknowledgments

The Authors wish to thank Michael John of the Vita-Salute San Raffaele University for the English language editing of this manuscript.

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Authors and Affiliations

  1. Anesthesia and Neurointensive Care, Department of Head and Neck, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy

    Francesco Ruggieri, Marco Gemma, Maria Rosa Calvi, Elisa Nicelli, Andrea Agarossi & Luigi Beretta

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  1. Francesco Ruggieri
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  2. Marco Gemma
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  3. Maria Rosa Calvi
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  4. Elisa Nicelli
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  5. Andrea Agarossi
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Correspondence to Francesco Ruggieri.

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Ruggieri, F., Gemma, M., Calvi, M.R. et al. Perioperative Serum Brain Natriuretic Peptide and Cardiac Troponin in Elective Intracranial Surgery. Neurocrit Care 17, 395–400 (2012). https://doi.org/10.1007/s12028-012-9684-2

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  • DOI: https://doi.org/10.1007/s12028-012-9684-2

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