Circulating adrenomedullin and B-type natriuretic peptide do not predict blood pressure fluctuations during pheochromocytoma resection: a cross-sectional study
Background Despite adequate presurgical management, blood pressure fluctuations are common during resection of pheochromocytoma or sympathetic paraganglioma (PPGL). To a large extent, the variability in blood pressure control during PPGL resection remains unexplained. Adrenomedullin and B-type natri...
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| Veröffentlicht in: | European journal of endocrinology 2021-10, Vol.185 (4), p.507-514 |
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| creator | Berends, Annika M A Buitenwerf, Edward Riphagen, Ineke J Lenders, Jacques W M Timmers, Henri J L M Kruijff, Schelto Links, Thera P van der Horst-Schrivers, Anouk N A Stegeman, Coen A Eekhoff, Elisabeth M W Feelders, Richard A Corssmit, Eleonora P M Groote Veldman, Ronald Haak, Harm R Muller Kobold, Anneke C Kerstens, Michiel N |
| description | Background Despite adequate presurgical management, blood pressure fluctuations are common during resection of pheochromocytoma or sympathetic paraganglioma (PPGL). To a large extent, the variability in blood pressure control during PPGL resection remains unexplained. Adrenomedullin and B-type natriuretic peptide, measured as MR-proADM and NT-proBNP, respectively, are circulating biomarkers of cardiovascular dysfunction. We investigated whether plasma levels of MR-proADM and NT-proBNP are associated with blood pressure fluctuations during PPGL resection. Methods Study subjects participated in PRESCRIPT, a randomized controlled trial in patients undergoing PPGL resection. MR-proADM and NT-proBNP were determined in a single plasma sample drawn before surgery. Multivariable linear and logistic regression analyses were used to explore associations between these biomarkers and blood pressure fluctuations, use of vasoconstrictive agents during surgery as well as the occurrence of perioperative cardiovascular events. Results A total of 126 PPGL patients were included. Median plasma concentrations of MR-proADM and NT-proBNP were 0.51 (0.41–0.63) nmol/L and 68.7 (27.9–150.4) ng/L, respectively. Neither MR-proADM nor NT-proBNP were associated with blood pressure fluctuations. There was a positive correlation between MR-proADM concentration and the cumulative dose of vasoconstrictive agents (03B2 0.44, P =0.001). Both MR-proADM and NT-proBNP were significantly associated with perioperative cardiovascular events (OR: 5.46, P =0.013 and OR: 1.54, P =0.017, respectively). Conclusions plasma MR-proADM or NT-proBNP should not be considered as biomarkers for the presurgical risk assessment of blood pressure fluctuations during PPGL resection. Future studies are needed to explore the potential influence of these biomarkers on the intraoperative requirement of vasoconstrictive agents and the perioperative cardiovascular risk. |
| doi_str_mv | 10.1530/EJE-20-1452 |
| format | Article |
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To a large extent, the variability in blood pressure control during PPGL resection remains unexplained. Adrenomedullin and B-type natriuretic peptide, measured as MR-proADM and NT-proBNP, respectively, are circulating biomarkers of cardiovascular dysfunction. We investigated whether plasma levels of MR-proADM and NT-proBNP are associated with blood pressure fluctuations during PPGL resection. Methods Study subjects participated in PRESCRIPT, a randomized controlled trial in patients undergoing PPGL resection. MR-proADM and NT-proBNP were determined in a single plasma sample drawn before surgery. Multivariable linear and logistic regression analyses were used to explore associations between these biomarkers and blood pressure fluctuations, use of vasoconstrictive agents during surgery as well as the occurrence of perioperative cardiovascular events. Results A total of 126 PPGL patients were included. Median plasma concentrations of MR-proADM and NT-proBNP were 0.51 (0.41–0.63) nmol/L and 68.7 (27.9–150.4) ng/L, respectively. Neither MR-proADM nor NT-proBNP were associated with blood pressure fluctuations. There was a positive correlation between MR-proADM concentration and the cumulative dose of vasoconstrictive agents (03B2 0.44, P =0.001). Both MR-proADM and NT-proBNP were significantly associated with perioperative cardiovascular events (OR: 5.46, P =0.013 and OR: 1.54, P =0.017, respectively). Conclusions plasma MR-proADM or NT-proBNP should not be considered as biomarkers for the presurgical risk assessment of blood pressure fluctuations during PPGL resection. Future studies are needed to explore the potential influence of these biomarkers on the intraoperative requirement of vasoconstrictive agents and the perioperative cardiovascular risk.</description><identifier>ISSN: 0804-4643</identifier><identifier>EISSN: 1479-683X</identifier><identifier>DOI: 10.1530/EJE-20-1452</identifier><identifier>PMID: 34324433</identifier><language>eng</language><publisher>England: Bioscientifica Ltd</publisher><subject>Adrenal Gland Neoplasms - blood ; Adrenal Gland Neoplasms - diagnosis ; Adrenal Gland Neoplasms - drug therapy ; Adrenal Gland Neoplasms - surgery ; Adrenergic Antagonists - therapeutic use ; Adrenomedullin ; Adrenomedullin - blood ; Adult ; Aged ; Biomarkers ; Biomarkers - blood ; Blood pressure ; Blood Pressure - physiology ; Brain natriuretic peptide ; Cardiovascular diseases ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - physiopathology ; Cardiovascular Diseases - prevention & control ; Clinical Study ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Heart Failure - blood ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart Failure - prevention & control ; Humans ; Intraoperative Complications - blood ; Intraoperative Complications - diagnosis ; Intraoperative Complications - physiopathology ; Intraoperative Complications - prevention & control ; Male ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Paraganglioma ; Patients ; Peptides ; Pheochromocytoma ; Pheochromocytoma - blood ; Pheochromocytoma - diagnosis ; Pheochromocytoma - drug therapy ; Pheochromocytoma - surgery ; Plasma ; Plasma levels ; Prognosis ; Risk Assessment ; Surgery ; Treatment Outcome</subject><ispartof>European journal of endocrinology, 2021-10, Vol.185 (4), p.507-514</ispartof><rights>European Society of Endocrinology</rights><rights>Copyright BioScientifica Ltd. Oct 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b396t-580b748ee01407988617416dc5539f1e3cf1a16b0a7c5cd6876a4b3a2bc77ee33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34324433$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berends, Annika M A</creatorcontrib><creatorcontrib>Buitenwerf, Edward</creatorcontrib><creatorcontrib>Riphagen, Ineke J</creatorcontrib><creatorcontrib>Lenders, Jacques W M</creatorcontrib><creatorcontrib>Timmers, Henri J L M</creatorcontrib><creatorcontrib>Kruijff, Schelto</creatorcontrib><creatorcontrib>Links, Thera P</creatorcontrib><creatorcontrib>van der Horst-Schrivers, Anouk N A</creatorcontrib><creatorcontrib>Stegeman, Coen A</creatorcontrib><creatorcontrib>Eekhoff, Elisabeth M W</creatorcontrib><creatorcontrib>Feelders, Richard A</creatorcontrib><creatorcontrib>Corssmit, Eleonora P M</creatorcontrib><creatorcontrib>Groote Veldman, Ronald</creatorcontrib><creatorcontrib>Haak, Harm R</creatorcontrib><creatorcontrib>Muller Kobold, Anneke C</creatorcontrib><creatorcontrib>Kerstens, Michiel N</creatorcontrib><title>Circulating adrenomedullin and B-type natriuretic peptide do not predict blood pressure fluctuations during pheochromocytoma resection: a cross-sectional study</title><title>European journal of endocrinology</title><addtitle>Eur J Endocrinol</addtitle><description>Background Despite adequate presurgical management, blood pressure fluctuations are common during resection of pheochromocytoma or sympathetic paraganglioma (PPGL). To a large extent, the variability in blood pressure control during PPGL resection remains unexplained. Adrenomedullin and B-type natriuretic peptide, measured as MR-proADM and NT-proBNP, respectively, are circulating biomarkers of cardiovascular dysfunction. We investigated whether plasma levels of MR-proADM and NT-proBNP are associated with blood pressure fluctuations during PPGL resection. Methods Study subjects participated in PRESCRIPT, a randomized controlled trial in patients undergoing PPGL resection. MR-proADM and NT-proBNP were determined in a single plasma sample drawn before surgery. Multivariable linear and logistic regression analyses were used to explore associations between these biomarkers and blood pressure fluctuations, use of vasoconstrictive agents during surgery as well as the occurrence of perioperative cardiovascular events. Results A total of 126 PPGL patients were included. Median plasma concentrations of MR-proADM and NT-proBNP were 0.51 (0.41–0.63) nmol/L and 68.7 (27.9–150.4) ng/L, respectively. Neither MR-proADM nor NT-proBNP were associated with blood pressure fluctuations. There was a positive correlation between MR-proADM concentration and the cumulative dose of vasoconstrictive agents (03B2 0.44, P =0.001). Both MR-proADM and NT-proBNP were significantly associated with perioperative cardiovascular events (OR: 5.46, P =0.013 and OR: 1.54, P =0.017, respectively). Conclusions plasma MR-proADM or NT-proBNP should not be considered as biomarkers for the presurgical risk assessment of blood pressure fluctuations during PPGL resection. Future studies are needed to explore the potential influence of these biomarkers on the intraoperative requirement of vasoconstrictive agents and the perioperative cardiovascular risk.</description><subject>Adrenal Gland Neoplasms - blood</subject><subject>Adrenal Gland Neoplasms - diagnosis</subject><subject>Adrenal Gland Neoplasms - drug therapy</subject><subject>Adrenal Gland Neoplasms - surgery</subject><subject>Adrenergic Antagonists - therapeutic use</subject><subject>Adrenomedullin</subject><subject>Adrenomedullin - blood</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Brain natriuretic peptide</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Clinical Study</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - prevention & control</subject><subject>Humans</subject><subject>Intraoperative Complications - blood</subject><subject>Intraoperative Complications - diagnosis</subject><subject>Intraoperative Complications - physiopathology</subject><subject>Intraoperative Complications - prevention & control</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Paraganglioma</subject><subject>Patients</subject><subject>Peptides</subject><subject>Pheochromocytoma</subject><subject>Pheochromocytoma - blood</subject><subject>Pheochromocytoma - diagnosis</subject><subject>Pheochromocytoma - drug therapy</subject><subject>Pheochromocytoma - surgery</subject><subject>Plasma</subject><subject>Plasma levels</subject><subject>Prognosis</subject><subject>Risk Assessment</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0804-4643</issn><issn>1479-683X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90buO1DAUBmALgdjZhYoeWaJBQgHfYid0y2iWi1aiAYkucuwT1qvEDr4U8zS8Kg4zUFBQ-dj69Mv2j9AzSl7TlpM3h0-HhpGGipY9QDsqVN_Ijn97iHakI6IRUvALdJnSPSG0zuQxuuCCMyE436GfexdNmXV2_jvWNoIPC9gyz85j7S1-1-TjCtjrHF2JkJ3BK6zZWcA2YB8yXiNYZzIe5xDstkupQjzNxeRSc4NP2Ja45a93EMxdDEswxxwWjSsGs5G3WGMTQ0rN-UDPOOVij0_Qo0nPCZ6e1yv09ebwZf-huf38_uP--rYZeS9z03ZkVKIDIFQQ1XedpEpQaU3b8n6iwM1ENZUj0cq0xspOSS1GrtlolALg_Aq9POWuMfwokPKwuGRgnrWHUNLA2lYx1lLeVfriH3ofSqw33pRSqhdSsqpendTvZ0WYhjW6RcfjQMmw9TbU3gZW59pb1c_PmWWs___X_imqAnoCowvJOPDZTc7o_4b-Aq9xppw</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Berends, Annika M A</creator><creator>Buitenwerf, Edward</creator><creator>Riphagen, Ineke J</creator><creator>Lenders, Jacques W M</creator><creator>Timmers, Henri J L M</creator><creator>Kruijff, Schelto</creator><creator>Links, Thera P</creator><creator>van der Horst-Schrivers, Anouk N A</creator><creator>Stegeman, Coen A</creator><creator>Eekhoff, Elisabeth M W</creator><creator>Feelders, Richard A</creator><creator>Corssmit, Eleonora P M</creator><creator>Groote Veldman, Ronald</creator><creator>Haak, Harm R</creator><creator>Muller Kobold, Anneke C</creator><creator>Kerstens, Michiel N</creator><general>Bioscientifica Ltd</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20211001</creationdate><title>Circulating adrenomedullin and B-type natriuretic peptide do not predict blood pressure fluctuations during pheochromocytoma resection: a cross-sectional study</title><author>Berends, Annika M A ; Buitenwerf, Edward ; Riphagen, Ineke J ; Lenders, Jacques W M ; Timmers, Henri J L M ; Kruijff, Schelto ; Links, Thera P ; van der Horst-Schrivers, Anouk N A ; Stegeman, Coen A ; Eekhoff, Elisabeth M W ; Feelders, Richard A ; Corssmit, Eleonora P M ; Groote Veldman, Ronald ; Haak, Harm R ; Muller Kobold, Anneke C ; Kerstens, Michiel N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b396t-580b748ee01407988617416dc5539f1e3cf1a16b0a7c5cd6876a4b3a2bc77ee33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adrenal Gland Neoplasms - blood</topic><topic>Adrenal Gland Neoplasms - diagnosis</topic><topic>Adrenal Gland Neoplasms - drug therapy</topic><topic>Adrenal Gland Neoplasms - surgery</topic><topic>Adrenergic Antagonists - therapeutic use</topic><topic>Adrenomedullin</topic><topic>Adrenomedullin - blood</topic><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Brain natriuretic peptide</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Clinical Study</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - prevention & control</topic><topic>Humans</topic><topic>Intraoperative Complications - blood</topic><topic>Intraoperative Complications - diagnosis</topic><topic>Intraoperative Complications - physiopathology</topic><topic>Intraoperative Complications - prevention & control</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Paraganglioma</topic><topic>Patients</topic><topic>Peptides</topic><topic>Pheochromocytoma</topic><topic>Pheochromocytoma - blood</topic><topic>Pheochromocytoma - diagnosis</topic><topic>Pheochromocytoma - drug therapy</topic><topic>Pheochromocytoma - surgery</topic><topic>Plasma</topic><topic>Plasma levels</topic><topic>Prognosis</topic><topic>Risk Assessment</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berends, Annika M A</creatorcontrib><creatorcontrib>Buitenwerf, Edward</creatorcontrib><creatorcontrib>Riphagen, Ineke J</creatorcontrib><creatorcontrib>Lenders, Jacques W M</creatorcontrib><creatorcontrib>Timmers, Henri J L M</creatorcontrib><creatorcontrib>Kruijff, Schelto</creatorcontrib><creatorcontrib>Links, Thera P</creatorcontrib><creatorcontrib>van der Horst-Schrivers, Anouk N A</creatorcontrib><creatorcontrib>Stegeman, Coen A</creatorcontrib><creatorcontrib>Eekhoff, Elisabeth M W</creatorcontrib><creatorcontrib>Feelders, Richard A</creatorcontrib><creatorcontrib>Corssmit, Eleonora P M</creatorcontrib><creatorcontrib>Groote Veldman, Ronald</creatorcontrib><creatorcontrib>Haak, Harm R</creatorcontrib><creatorcontrib>Muller Kobold, Anneke C</creatorcontrib><creatorcontrib>Kerstens, Michiel N</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berends, Annika M A</au><au>Buitenwerf, Edward</au><au>Riphagen, Ineke J</au><au>Lenders, Jacques W M</au><au>Timmers, Henri J L M</au><au>Kruijff, Schelto</au><au>Links, Thera P</au><au>van der Horst-Schrivers, Anouk N A</au><au>Stegeman, Coen A</au><au>Eekhoff, Elisabeth M W</au><au>Feelders, Richard A</au><au>Corssmit, Eleonora P M</au><au>Groote Veldman, Ronald</au><au>Haak, Harm R</au><au>Muller Kobold, Anneke C</au><au>Kerstens, Michiel N</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Circulating adrenomedullin and B-type natriuretic peptide do not predict blood pressure fluctuations during pheochromocytoma resection: a cross-sectional study</atitle><jtitle>European journal of endocrinology</jtitle><addtitle>Eur J Endocrinol</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>185</volume><issue>4</issue><spage>507</spage><epage>514</epage><pages>507-514</pages><issn>0804-4643</issn><eissn>1479-683X</eissn><abstract>Background Despite adequate presurgical management, blood pressure fluctuations are common during resection of pheochromocytoma or sympathetic paraganglioma (PPGL). To a large extent, the variability in blood pressure control during PPGL resection remains unexplained. Adrenomedullin and B-type natriuretic peptide, measured as MR-proADM and NT-proBNP, respectively, are circulating biomarkers of cardiovascular dysfunction. We investigated whether plasma levels of MR-proADM and NT-proBNP are associated with blood pressure fluctuations during PPGL resection. Methods Study subjects participated in PRESCRIPT, a randomized controlled trial in patients undergoing PPGL resection. MR-proADM and NT-proBNP were determined in a single plasma sample drawn before surgery. Multivariable linear and logistic regression analyses were used to explore associations between these biomarkers and blood pressure fluctuations, use of vasoconstrictive agents during surgery as well as the occurrence of perioperative cardiovascular events. Results A total of 126 PPGL patients were included. Median plasma concentrations of MR-proADM and NT-proBNP were 0.51 (0.41–0.63) nmol/L and 68.7 (27.9–150.4) ng/L, respectively. Neither MR-proADM nor NT-proBNP were associated with blood pressure fluctuations. There was a positive correlation between MR-proADM concentration and the cumulative dose of vasoconstrictive agents (03B2 0.44, P =0.001). Both MR-proADM and NT-proBNP were significantly associated with perioperative cardiovascular events (OR: 5.46, P =0.013 and OR: 1.54, P =0.017, respectively). Conclusions plasma MR-proADM or NT-proBNP should not be considered as biomarkers for the presurgical risk assessment of blood pressure fluctuations during PPGL resection. Future studies are needed to explore the potential influence of these biomarkers on the intraoperative requirement of vasoconstrictive agents and the perioperative cardiovascular risk.</abstract><cop>England</cop><pub>Bioscientifica Ltd</pub><pmid>34324433</pmid><doi>10.1530/EJE-20-1452</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adrenal Gland Neoplasms - blood Adrenal Gland Neoplasms - diagnosis Adrenal Gland Neoplasms - drug therapy Adrenal Gland Neoplasms - surgery Adrenergic Antagonists - therapeutic use Adrenomedullin Adrenomedullin - blood Adult Aged Biomarkers Biomarkers - blood Blood pressure Blood Pressure - physiology Brain natriuretic peptide Cardiovascular diseases Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Cardiovascular Diseases - physiopathology Cardiovascular Diseases - prevention & control Clinical Study Cross-Sectional Studies Female Follow-Up Studies Heart Failure - blood Heart Failure - diagnosis Heart Failure - physiopathology Heart Failure - prevention & control Humans Intraoperative Complications - blood Intraoperative Complications - diagnosis Intraoperative Complications - physiopathology Intraoperative Complications - prevention & control Male Middle Aged Natriuretic Peptide, Brain - blood Paraganglioma Patients Peptides Pheochromocytoma Pheochromocytoma - blood Pheochromocytoma - diagnosis Pheochromocytoma - drug therapy Pheochromocytoma - surgery Plasma Plasma levels Prognosis Risk Assessment Surgery Treatment Outcome |
| title | Circulating adrenomedullin and B-type natriuretic peptide do not predict blood pressure fluctuations during pheochromocytoma resection: a cross-sectional study |
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