| Affiliation: | (1) Department of Medicine III, Klinikum Kröllwitz, Martin Luther University, Ernst-Grube-Strasse 42, 06097 Halle, Germany;(2) Institute of Clinical Chemistry, Ludwig Maximilian University, Munich, Germany;(3) Department of Medicine I, Klinikum Großhadern, Ludwig Maximilian University, Munich, Germany;(4) Department of Anesthesiology, Bergmannstrost Hospital, Germany;(5) Department of Anesthesiology, Hospital Ludwigsburg, Ludwigsburg, Germany;(6) Department of Aneasthesiology, Medizinische Hochschule Hannover, Hanover, Germany |
| Abstract: | Objective Interest has recently focused on the use of neurohormonal markers such as atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) as indices of left ventricular systolic dysfunction and prognosis in heart failure. Also, peptides belonging to the interleukin-6 (IL-6) family have been shown to induce ANP and BNP secretion. We hypothesized that BNP and ANP spillover in the peripheral circulation reflects left ventricular dysfunction and IL-6 production in septic shock.Design and setting Retrospective, clinical study in the medical intensive care unit of a university hospital.Patients and participants 17 patients with septic shock and 19 control subjects.Interventions Collection of clinical and demographic data in relation to ANP, BNP, IL-6, and soluble TNF receptors (sTNF-R-p55, sTNF-R-p75) in plasma over a period of 4 days.Measurements and results In septic shock we found a significant increase in ANP (82.7±9.9 vs. 14.9±1.2 pg/ml) and BNP (12.4±3.6 vs. 5.5±0.7 pg/ml). Plasma ANP peaked together with IL-6. Peaks of ANP and IL-6 were significantly correlated (r=0.73; p<0.01). BNP was inversely correlated to cardiac index (r=–0.56; p<0.05).Conclusions ANP and BNP increase significantly in patients with septic shock. BNP reflects left ventricular dysfunction. ANP is related to IL-6 production rather than to cardiovascular dysfunction. |
