Usefulness of an elevated B-type natriuretic peptide to predict allograft failure, cardiac allograft vasculopathy, and survival after heart transplantation
Section snippets
Study design
We examined 66 consecutive adult patients who underwent primary heart transplantation and who were stable beyond the first year. At the time of inclusion into the study, patients could not have evidence of ongoing allograft rejection, severe allograft dysfunction (defined as left ventricular ejection fraction [LVEF] <0.30), or angiographic coronary artery disease. Four patients were excluded due to inadequate follow-up (lost to follow-up) or end-stage renal disease that required dialysis
Baseline characteristics
Of 62 heart transplant recipients, 39 had low levels of BNP (<250 pg/ml) and 23 exhibited high levels of BNP (≥250 pg/ml). Median levels of BNP in the 2 groups were 70 pg/ml (range 7 to 209) and 592 pg/ml (range 268 to 3,800), respectively (p <0.0001). Thus, the cutpoints developed provided robust discrimination of BNP levels. There were no significant differences with regard to recipient's age, gender, race, and years after transplantation. Similarly, no differences in metabolic variables,
Discussion
This investigation found an important prognostic relation of high BNP levels with cardiac outcomes in patients long after heart transplantation. BNP, a marker of allograft function, was closely related to allograft failure and development of cardiac allograft vasculopathy and may serve as an important marker for likelihood of cardiac death. Because BNP reflects ventricular wall stress and pressure, levels of this hormone in recipients of heart transplants have been studied as an indicator of
References (8)
- et al.
Usefulness of B-type natriuretic peptide levels in predicting hemodynamic perturbations after heart transplantation despite preserved left ventricular systolic function
Am J Cardiol
(2002) - et al.
Significance of raised natriuretic peptides after bicaval and standard cardiac transplantation
Ann Thorac Surg
(1997) - et al.
Transient reduction without normalization of brain natriuretic peptide early after heart transplantation
J Thorac Cardiovasc Surg
(1998) - et al.
Plasma concentrations and comparisons of brain natriuretic peptide and atrial natriuretic peptide in normal subjects, cardiac transplant recipients and patients with dialysis-independent or dialysis-dependent chronic renal failure
Clin Sci
(1992)