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Predictive value of brain natriuretic peptide in the diagnosis of heart transplant rejection.
J Heart Lung Transplant. 2004 Jul; 23(7):850-6.JH

Abstract

AIM

To evaluate the pattern of brain natriuretic peptide (BNP) concentration in heart transplant (HT) recipients and its relation to the degree of graft rejection determined by endomyocardial biopsy specimen.

METHODS

We studied 71 consecutive HT recipients (62 men, 53 +/- 11 years). The patients underwent 383 biopsies. Creatinine and BNP concentrations and hemodynamic parameters were determined along with the degree of graft rejection using endomyocardial biopsy specimens. We considered treatable rejection as International Society for Heart and Lung Transplantation Grade >or=2 in the first 90 days and >or=3A thereafter. We included a control group of 36 healthy individuals.

RESULTS

Brain natriuretic peptide concentration was significantly greater among HT recipients (264 +/- 318 pg/ml) than in controls (17 +/- 16 pg/ml). In the first 90 days, BNP concentration was significantly greater among the patients with graft rejection (510 +/- 470, n = 84, vs 278 +/- 255, n = 87; p < 0.0001), although the corresponding discriminatory capacity was small. After the first 90 days, BNP values were similar in patients with and without graft rejection (170 +/- 297, n = 17, vs 142 +/- 203, n = 195; p = not significant). Creatinine concentration increased with time after transplantation and did not correlate with BNP concentration. We observed significant positive correlation between BNP concentration and hemodynamic parameters.

CONCLUSIONS

Brain natriuretic peptide concentration remains increased after HT, with stabilization after the 4th month. Brain natriuretic peptide concentrations are slightly greater among patients with treatable rejection, particularly in the first 90 days, although BNP concentration lacks discriminatory capacity to serve as a guide to performing biopsy.

Authors+Show Affiliations

Cardiology La Fe University Hospital, Valencia, Spain. shatto@servitel.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15261180

Citation

Arnau-Vives, Miguel A., et al. "Predictive Value of Brain Natriuretic Peptide in the Diagnosis of Heart Transplant Rejection." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 23, no. 7, 2004, pp. 850-6.
Arnau-Vives MA, Almenar L, Hervas I, et al. Predictive value of brain natriuretic peptide in the diagnosis of heart transplant rejection. J Heart Lung Transplant. 2004;23(7):850-6.
Arnau-Vives, M. A., Almenar, L., Hervas, I., Osa, A., Martinez-Dolz, L., Rueda, J., Zorio, E., Martinez-Ortiz De Urbina, L., Perez, J. L., Mateo, A., & Palencia, M. (2004). Predictive value of brain natriuretic peptide in the diagnosis of heart transplant rejection. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 23(7), 850-6.
Arnau-Vives MA, et al. Predictive Value of Brain Natriuretic Peptide in the Diagnosis of Heart Transplant Rejection. J Heart Lung Transplant. 2004;23(7):850-6. PubMed PMID: 15261180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive value of brain natriuretic peptide in the diagnosis of heart transplant rejection. AU - Arnau-Vives,Miguel A, AU - Almenar,Luis, AU - Hervas,Isabel, AU - Osa,Ana, AU - Martinez-Dolz,Luis, AU - Rueda,Joaquin, AU - Zorio,Esther, AU - Martinez-Ortiz De Urbina,Luis, AU - Perez,Jose L, AU - Mateo,Antonio, AU - Palencia,Miguel, PY - 2003/02/21/received PY - 2003/08/04/revised PY - 2003/08/06/accepted PY - 2004/7/21/pubmed PY - 2004/10/22/medline PY - 2004/7/21/entrez SP - 850 EP - 6 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J Heart Lung Transplant VL - 23 IS - 7 N2 - AIM: To evaluate the pattern of brain natriuretic peptide (BNP) concentration in heart transplant (HT) recipients and its relation to the degree of graft rejection determined by endomyocardial biopsy specimen. METHODS: We studied 71 consecutive HT recipients (62 men, 53 +/- 11 years). The patients underwent 383 biopsies. Creatinine and BNP concentrations and hemodynamic parameters were determined along with the degree of graft rejection using endomyocardial biopsy specimens. We considered treatable rejection as International Society for Heart and Lung Transplantation Grade >or=2 in the first 90 days and >or=3A thereafter. We included a control group of 36 healthy individuals. RESULTS: Brain natriuretic peptide concentration was significantly greater among HT recipients (264 +/- 318 pg/ml) than in controls (17 +/- 16 pg/ml). In the first 90 days, BNP concentration was significantly greater among the patients with graft rejection (510 +/- 470, n = 84, vs 278 +/- 255, n = 87; p < 0.0001), although the corresponding discriminatory capacity was small. After the first 90 days, BNP values were similar in patients with and without graft rejection (170 +/- 297, n = 17, vs 142 +/- 203, n = 195; p = not significant). Creatinine concentration increased with time after transplantation and did not correlate with BNP concentration. We observed significant positive correlation between BNP concentration and hemodynamic parameters. CONCLUSIONS: Brain natriuretic peptide concentration remains increased after HT, with stabilization after the 4th month. Brain natriuretic peptide concentrations are slightly greater among patients with treatable rejection, particularly in the first 90 days, although BNP concentration lacks discriminatory capacity to serve as a guide to performing biopsy. SN - 1053-2498 UR - https://www.unboundmedicine.com/medline/citation/15261180/Predictive_value_of_brain_natriuretic_peptide_in_the_diagnosis_of_heart_transplant_rejection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053249803003966 DB - PRIME DP - Unbound Medicine ER -