Probrain Natriuretic Peptide and C-Reactive Protein as Markers of Acute Rejection, Allograft Vasculopathy, and Mortality in Heart Transplantation

Arora, Satish; Gullestad, Lars; Wergeland, Ragnhild; Simonsen, Svein; Holm, Torbjörn; Hognestad, Aina; Ueland, Thor; Geiran, Odd; Andreassen, Arne K.

doi:10.1097/01.tp.0000263338.39555.21

Cited by 44 publications

(45 citation statements)

References 126 publications

(119 reference statements)

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“…Given (10) and is supported by the results of other ex vivo and in vivo VH-IVUS studies performed amongst patients with IHD (11)(12)(13)(14). (3,15). All biomarker assays were performed upon study closure to minimize differences related to run variability.…”

Section: In the Present Study We Aimed To Evaluate The Relationship Bmentioning

confidence: 62%

Systemic Markers of Inflammation Are Associated with Cardiac Allograft Vasculopathy and an Increased Intimal Inflammatory Component

Arora

Günther

Wennerblom

et al. 2010

American Journal of Transplantation

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We evaluated an extensive profile of clinical variables and immune markers to assess the inflammatory milieu associated with cardiac allograft vasculopathy (CAV) assessed by intravascular ultrasound (IVUS) and virtual histology (VH). In total, 101 heart transplant (HTx) recipients were included and underwent IVUS/VH examination and measurement of plasma C-reactive protein (CRP), soluble tumor necrosis factor receptor-1, interleukin-6, osteoprotegerin, soluble gp130, von Willebrand factor, vascular cell adhesion molecule-1 (VCAM-1) and neopterin. Mean Maximal Intimal Thickness (MIT) was 0.61 ± 0.19 mm and mean fibrotic, fibrofatty, dense calcified and necrotic core components were 55 ± 15, 14 ± 10, 15 ± 13 and 17 ± 9%, respectively. In multivariate analysis, CRP > 1.

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Section: In the Present Study We Aimed To Evaluate The Relationship Bmentioning

confidence: 62%

Systemic Markers of Inflammation Are Associated with Cardiac Allograft Vasculopathy and an Increased Intimal Inflammatory Component

Arora

Günther

Wennerblom

et al. 2010

American Journal of Transplantation

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“…Plasma levels of vascular endothelial growth factor (vEGF), interleukin (IL)-8, vascular cell adhesion molecule (VCAM)-1 and soluble tumor necrosis factor receptor (sTNFR)-1 were measured by enzyme immunoassays (EIA) (R&D Systems, Minneapolis, MN). Plasma levels of C-reactive protein (CRP) and von Willebrand factor (vWf) were measured by EIAs as previously described (16). All intra-assay and interassay coefficients of variance were <10%.…”

Section: Inflammatory Marker Analysismentioning

confidence: 99%

The Effect of Everolimus Initiation and Calcineurin Inhibitor Elimination on Cardiac Allograft Vasculopathy in De Novo Recipients: One-Year Results of a Scandinavian Randomized Trial

Arora

Andreassen

Andersson

et al. 2015

American Journal of Transplantation

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Early initiation of everolimus with calcineurin inhibitor therapy has been shown to reduce the progression of cardiac allograft vasculopathy (CAV) in de novo heart transplant recipients. The effect of de novo everolimus therapy and early total elimination of calcineurin inhibitor therapy has, however, not been investigated and is relevant given the morbidity and lack of efficacy of current protocols in preventing CAV. This 12‐month multicenter Scandinavian trial randomized 115 de novo heart transplant recipients to everolimus with complete calcineurin inhibitor elimination 7–11 weeks after HTx or standard cyclosporine immunosuppression. Ninety‐five (83%) patients had matched intravascular ultrasound examinations at baseline and 12 months. Mean (± SD) recipient age was 49.9 ± 13.1 years. The everolimus group (n = 47) demonstrated significantly reduced CAV progression as compared to the calcineurin inhibitor group (n = 48) (ΔMaximal Intimal Thickness 0.03 ± 0.06 and 0.08 ± 0.12 mm, ΔPercent Atheroma Volume 1.3 ± 2.3 and 4.2 ± 5.0%, ΔTotal Atheroma Volume 1.1 ± 19.2 mm3 and 13.8 ± 28.0 mm3 [all p‐values ≤ 0.01]). Everolimus patients also had a significantly greater decline in levels of soluble tumor necrosis factor receptor‐1 as compared to the calcineurin inhibitor group (p = 0.02). These preliminary results suggest that an everolimus‐based CNI‐free can potentially be considered in suitable de novo HTx recipients.

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“…199 Brain natriuretic peptide (BNP), a polypeptide released in the ventricles in response to increased pressure and stretching of cardiomyocytes, has been used as a marker to assess acute and chronic cardiac rejection. 200,201 More recently, proteomic evidence generated using human samples has correlated proinflammatory cytokines with circulating BNP levels during acute cellular cardiac rejection. 200,201 However, there remains a lack of evidence that directly implicates BNP upregulation as a contributor in the acute rejection process.…”

Section: Beyond the Classical Components Of Acute Cellular And Antibomentioning

confidence: 99%

“…200,201 More recently, proteomic evidence generated using human samples has correlated proinflammatory cytokines with circulating BNP levels during acute cellular cardiac rejection. 200,201 However, there remains a lack of evidence that directly implicates BNP upregulation as a contributor in the acute rejection process.…”

Section: Beyond the Classical Components Of Acute Cellular And Antibomentioning

confidence: 99%

Inflammation in Myocardial Diseases

Marchant

Boyd

Lin

et al. 2012

Circulation Research

252

165

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Inflammatory processes underlie a broad spectrum of conditions that injure the heart muscle and cause both structural and functional deficits. In this article, we address current knowledge regarding 4 common forms of myocardial inflammation: myocardial ischemia and reperfusion, sepsis, viral myocarditis, and immune rejection. Each of these pathological states has its own unique features in pathogenesis and disease evolution, but all reflect inflammatory mechanisms that are partially shared. From the point of injury to the mobilization of innate and adaptive immune responses and inflammatory amplification, the cellular and soluble mediators and mechanisms examined in this review will be discussed with a view that both beneficial and adverse consequences arise in these human conditions. (Circ Res. 2012;110:126-144.)

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Probrain Natriuretic Peptide and C-Reactive Protein as Markers of Acute Rejection, Allograft Vasculopathy, and Mortality in Heart Transplantation

Abstract: In HTx recipients, NT-proBNP and CRP are not useful as markers of acute cellular rejection during the first year postHTx, but combined analysis adds significantly to their predictive value for development of CAV and all-cause mortality.

Cited by 44 publications

References 126 publications

Systemic Markers of Inflammation Are Associated with Cardiac Allograft Vasculopathy and an Increased Intimal Inflammatory Component

Systemic Markers of Inflammation Are Associated with Cardiac Allograft Vasculopathy and an Increased Intimal Inflammatory Component

The Effect of Everolimus Initiation and Calcineurin Inhibitor Elimination on Cardiac Allograft Vasculopathy in De Novo Recipients: One-Year Results of a Scandinavian Randomized Trial

Inflammation in Myocardial Diseases

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