Evaluation of plasma cyclic GMP assay as a screening test for detection of acute cardiac allograft rejection.
Our aim was to assess the value of a single determination of plasma cyclic guanosine 3',5'-monophosphate (cGMP) in noninvasive screening for acute cardiac allograft rejection warranting augmentation of immunosuppression. Plasma cGMP levels were measured in 26 patients 1 to 13 months after heart transplantation on the same day the endomyocardial biopsies were performed. Acute moderate rejection (ISHLT 3A or 3B) was found in 10 out of 17 subjects (59%) with plasma cGMP >5 nmol/L, whereas there was mild or no rejection (ISHLT 0 to 1) in 8 from among 9 subjects (89%) with cGMP <5 nmol/L. Because cGMP levels <5 nmol/L appear to argue against the presence of acute rejection requiring therapy modification, our preliminary results suggest that a single plasma cGMP assay might be helpful in establishing indications for endomyocardial biopsy in heart transplant recipients.
Stobierska-Dzierzek
B
B
Coronary Disease Department, Collegium Medicum, Jagiellonian University, Cracow, Poland.
Surdacki
A
A
Frasik
W
W
Dziatkowiak
A
A
Pietrucha
A
A
Herman
Z S
ZS
Piwowarska
W
W
D000208:Acute Disease; D000328:Adult; D006152:Cyclic GMP / Q000097:blood*; D004699:Endocardium / Q000473:pathology; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D016027:Heart Transplantation / Q000473:pathology / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D006152:Cyclic GMP