Cruise, Braden2025-08-262025-08-262025-08-212025-08-212025-08-25http://hdl.handle.net/1993/39260Background: Postoperative atrial fibrillation following lung resection is associated with increased morbidity and mortality. The extent of pulmonary resection and preoperative N terminal pro-BNP (NT-proBNP) levels have been suggested as contributing factors in the development of postoperative atrial fibrillation. This study aims to determine if a relationship exists between the extent of lung parenchyma resected and perioperative changes in serum NT-proBNP levels. Methods: We conducted a prospective cohort study enrolling patients aged ≥55 years undergoing pulmonary resection with no documented history of atrial fibrillation. Baseline NT-proBNP levels were measured preoperatively (PRE), in the post-anesthesia care unit (PACU), and on postoperative day 1 (POD1). The weight and volume of lung resection was determined from pathological review of the surgical specimen. Statistical analysis utilized repeated measure regression models with NT-proBNP as the outcome, incorporating measurement time (PRE/PACU/POD1), the extent of lung resection, and their interaction as predictor variables. Trajectory plots were generated to assess NT-proBNP changes after surgery and Spearman correlations were used to determine the relationship between NT-proBNP and extent of resection at each time point. Results: 105 patients were enrolled, and 102 patients were analyzed. Postoperative atrial fibrillation occurred in 5 (4.9%) cases. Relative to PRE NT-proBNP measurements, the change in NT-proBNP levels at PACU and POD1 was -0.5 ± 37.9 pg/mL (p=0.905) and 320 ± 472.5 pg/mL (p <0.0001), respectively. No relationship between NT-proBNP and the extent of lung resection, defined using multiple outcomes, was demonstrated across all measurement times. Conclusions: Lung resection was followed by a near four-fold elevation in NT-proBNP levels from baseline on the first postoperative day. However, there was no relationship between perioperative elevations in NT-proBNP and the extent of lung resection.engAtrial fibrillationThoracic surgeryPerioperative medicineLung resection