Estimation of the Risk of Postoperative Hypertension Following Minor to Moderate Surgery Using an Echocardiogram and Biomarkers
-
- Shidou Rumi
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Kohjitani Atsushi
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Miyata Masaaki
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Yamashita Kaoru
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Ohno Sachi
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Ohishi Mitsuru
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
-
- Sugimura Mitsutaka
- Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Kagoshima University
この論文をさがす
説明
<p>This study aimed to determine independent factors for developing postoperative hypertension using 4 biomarkers in patients receiving oral and maxillofacial surgery under general anesthesia. Brain natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity myocardial troponin T (hs-TnT), and high-sensitivity myocardial troponin I (hs-TnI) were measured and preoperative echocardiograms were examined. Episodes of systolic blood pressure (SBP) ≥ 170 mmHg or diastolic blood pressure ≥ 100 mmHg within 1 week after surgery were considered postoperative hypertension. We analyzed 213 (130 men; 83 women) patients, who were divided into a postoperative hypertension group (HT group, n = 32) and a normal group (N group, n = 181). The HT group showed a higher LVMI (113.5 versus 100.1), higher E/e' of the lateral wall (9.1 versus 7.7), and higher BNP (39.2 versus 22.9 pg/mL), NT-proBNP (400.1 versus 143.9 pg/mL), and hs-TnT (15.6 versus 10.3 ng/L) concentrations compared to the N group. NT-proBNP and hs-TnT concentrations positively associated with E/e', but BNP and hs-TnI did not. NT-proBNP (AUC = 0.64, cutoff value: 117.0 pg/mL) and hs-TnT (AUC = 0.61, cutoff value: 11.0 ng/L) concentrations were effective for discriminating E/e' ≥ 12. Multivariate logistic regression analyses showed that risk factors responsible for developing postoperative hypertension were NT-proBNP and hs-TnT using biomarkers and E/e' as independent variables, and NT-proBNP and SBP at admission using biomarkers and SBP at admission as independent variables. These findings suggest that NT-proBNP and hs-TnT concentrations, and SBP at admission, are useful to predict postoperative hypertension after minor to moderate surgery, and that left ventricular filling pressure is a primary factor associated with postoperative hypertension.</p>
収録刊行物
-
- International Heart Journal
-
International Heart Journal 63 (3), 558-565, 2022-05-30
一般社団法人 インターナショナル・ハート・ジャーナル刊行会