Cardiac transplantation affects ventricular expression of brain natriuretic peptide

Abstract

High levels of BNP are synthesised and secreted by the transplanted human ventricle, and the transplanted ventricle may be an important source of circulating BNP. The significant positive association between ventricular BNP and time after transplant suggests a possible self compensatory mechanism or functional adaptation of the transplanted heart which may be beneficial to ventricular function.

Ventricular natriuretic peptide (BNP) in heart transplantation: BNP correlation with endomyocardial biopsy, laboratory and hemodynamic measures

“…In agreement with our study, most authors have found that BNP concentration remained high after transplantation, and were significantly higher than in healthy controls. [28][29][30] Ationu et al 28 and El Gamel et al 29 likewise found no relation between BNP plasma levels and the existence of heart rejection as determined by biopsy. Masters et al 31 analyzed 77 biopsies in 10 patients between 4 and 40 weeks post-HT.…”

“…Ationu et al 28 found no correlation between ventricular BNP (closely related to plasma BNP) and the right ventricular pressures or any other hemodynamic variable, while in contrast El Gamel et al 29 obtained a good positive correlation to the transpulmonary gradient-although in both cases the number of patients involved was relatively small.…”

“…20 High BNP values have also been found in patients with high blood pressure, ventricular hypertrophy, ischemic heart disease and other heart diseases, [21][22][23][24][25][26] renal failure subjected to hemodialysis, 12,27 and in heart transplantation. [28][29][30] The utility of BNP in the diagnosis of heart transplant rejection has not been thoroughly investigated to date; the studies were generally limited to few cases with a short follow-up duration and sometimes contradictory results. 31,32 In this context, the simple laboratory assessment of BNP could be very useful in selecting patients for subsequent invasive techniques such as biopsy.…”

Pioglitazone does not modify ANP levels of type 2 diabetic patients

“…First, heart denervation or partial reinnervation may not have a role in the regulation of ANP balance [8,9]. Therefore a partial defect of sympathetic system is not relevant in the regulation of ANP plasma concentration, while chronic hyperglycemia (in type 2 diabetic patients with and without transplantation) induces elevated levels of plasma ANP levels regardless of chronic hyperinsulinemia.…”

“…In heart transplant recipients high levels of ANP were found after surgery [8,9], thereafter normalized to physiological levels [10] or, according to some other reports [11], remained persistently high values. We previously showed that diabetic heart transplanted patients, had elevated plasma ANP concentrations similarly to the not transplanted diabetic patients.…”