Value of plasma B-type natriuretic peptide as a marker for rejection in pediatric heart transplant recipients

Lindblade, Christopher; Chun, David S.; Darragh, Robert K.; Caldwell, Randall L.; Murphy, Debbie; Schamberger, Marcus S.

doi:10.1016/j.amjcard.2004.11.054

Cited by 32 publications

(26 citation statements)

References 12 publications

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“…Others also have reported more recently an association between plasma BNP and cardiac cellular rejection [28–31]. Similar findings were seen in pediatric cardiac allograft recipients [32, 33]. Finally, plasma BNP or NT-proBNP levels in postcardiac transplantation strongly and independently predicted cardiac mortality [34, 35].…”

Section: Plasma Bnp In Acute Cardiac Allograft Rejectionsupporting

confidence: 55%

Brain Natriuretic Peptide Production and Secretion in Inflammation

Ogawa

Bold

2012

Journal of Transplantation

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Gene expression and secretion of the cardiac polypeptide hormones atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP) are simultaneously upregulated in various cardiac disorders such as congestive heart failure, ischemic heart disease, and hypertensive heart disease, in which hemodynamic or neuroendocrine changes are key components in the progression of disease. However, during acute cardiac allograft rejection, plasma BNP levels are increased but not those of ANF. Successful treatment of the rejection episode decreases the elevated plasma BNP to prerejection values suggesting that substances related to inflammation may selectively influence BNP gene expression. Indeed, cytokines such as TNFα and IL-1β selectively stimulate cardiac BNP at the transcriptional and translational levels in cardiomyocyte cultures without affecting ANF. This selective BNP increase is seen in vivo, in addition to acute cardiac allograft rejection, in several circumstances where inflammation significantly contributes to the pathogenesis of disease such as in sepsis and in acute myocarditis.

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Section: Plasma Bnp In Acute Cardiac Allograft Rejectionsupporting

confidence: 55%

Brain Natriuretic Peptide Production and Secretion in Inflammation

Ogawa

Bold

2012

Journal of Transplantation

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“…Sequential values appear to be of greater value than a single measurement. This was also shown for cardiac transplant patients—the change of NT-proBNP over time correlated with their wellbeing, not the absolute value [22, 23]. The baseline value may be of prognostic significance.…”

Section: Discussionmentioning

confidence: 92%

Aminoterminal Pro B-Type Natriuretic Peptide (NT-proBNP) Levels for Monitoring Interventions in Paediatric Cardiac Patients with Stenotic Lesions

Welisch

Kleesiek

Haas

et al. 2009

International Journal of Pediatrics

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Background. Serum concentration of NT-proBNP correlates well with the severity of cardiac disease in adults. Few studies have been performed on the applicability of NT-proBNP for monitoring children with congenital heart disease. Objective. To assess the potential of NT-proBNP for monitoring the success of interventions in children with stenotic cardiac lesions. Methods. NT-proBNP was measured in 42 children aged 1 day to 17 years (y) before and 6 to 12 weeks after surgical or interventional correction of obstructive lesions of the heart. Comparison is made with the clinical status and echocardiographic data of the child. Results. NT-proBNP levels (median 280, range 10–263,000 pg/mL) were above the reference value in all but 6 patients (pts) prior to the intervention. Higher levels were found in more compromised patients. The 35 children with clinical improvement after the procedure showed a decline of their NT-proBNP level in all but 4 patients, whose levels remained unchanged. Five patients with unchanged gradients despite a therapeutic intervention also demonstrated unchanged NT-proBNP levels after the intervention. Thus, the success rate of the procedure correlated well to clinical and echocardiographic findings. Conclusion. NT-proBNP can be used to assess the efficiency of an intervention.

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“…Prior reports on pediatric patients have also found a relationship between graft pathology and BNP levels; however, those reports were limited by small numbers of patients and few episodes of graft rejection. 28,29 It is of interest to note that some patients are clinically stable and have elevated BNP levels without evidence of AR. This may reflect sub-clinical evidence of graft dysfunction.…”

Section: Discussionmentioning

confidence: 98%