Significance of Raised Natriuretic Peptides After Bicaval and Standard Cardiac Transplantation

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

“…We found no relationship between BNP levels and creatinine concentration, with the latter increasing over time. El Gamel et al 29 obtained similar results in a group of 40 HT patients. Earlier studies had shown that patients with chronic renal failure enrolled in a hemodialysis program exhibited increased BNP levels.…”

“…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.…”

“…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.…”

N-Terminal pro-Brain natriuretic peptide as a potential non-invasive marker of cardiac transplantation rejection

“…13 ANP elevation in post-transplanted patients is the normal physiological response to the hypertension and increased retention of water and salt. 11 In these patients, activation of the vasopressin and renin--angiotensin--aldosterone system takes place due to the cardiac denervation and the treatment with cyclosporine A. Cardiac natriuretic peptides spontaneously antagonize this e¡ect. 11 In the present work, raised NT-proBNP and cTnTconcentrations were observed in all of the patients just after transplantation.…”

“…In the ¢rst few days after transplantation, high plasma concentrations of natriuretic peptides are found, even after left ventricular function is restored. 11,12 Atrial natriuretic peptide (ANP) plasma concentrations signi¢cantly decrease in the two months post-transplantation, and no further alterations are observed during the ¢rst year. 12 However, brain natriuretic peptide (BNP) concentrations decrease throughout the ¢rst year after transplantation; they do not reach normal values, although they plateau after the fourth or the ¢fth month.…”