title: Brain natriuretic peptide levels do not correlate with acute cellular rejection in De Novo orthotopic heart transplant recipients.
abstract: BACKGROUND
  The changes in brain natriuretic peptide (BNP) levels after orthotopic heart transplantation have not been previously described. The use of brain natriuretic peptide levels as a surrogate marker for cellular rejection remains controversial, with conflicting data.
  
  
  METHODS
  We prospectively evaluated the potential utility of BNP levels in the first 6 months after transplantation and sought correlation with histologic grade of rejection and hemodynamic status.
  
  
  RESULTS
  Thirty-five patients and 265 biopsy samples were included in the study. BNP levels did not correlate with histologic grade of rejection. They showed good correlation with central venous pressure and pulmonary capillary wedge pressure. BNP levels were elevated after transplant and showed a steep time-dependent decline. BNP levels correlated with echocardiographically derived indices of diastolic dysfunction.
  
  
  CONCLUSIONS
  BNP levels are not a surrogate marker for rejection in the first 2 months after orthotopic heart transplantation and do not obviate the necessity for endomyocardial biopsy. Whether BNP levels have long-term prognostic significance is unclear and remains the subject of ongoing prospective study.
authors.affiliation: Kaufman Centre for Heart Failure, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: James O
authors.initials: JO
authors.lastname: O'Neill
authors.forename: Andrew T
authors.initials: AT
authors.lastname: McRae
authors.forename: Richard W
authors.initials: RW
authors.lastname: Troughton
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ng
authors.forename: David O
authors.initials: DO
authors.lastname: Taylor
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Yamani
authors.forename: James B
authors.initials: JB
authors.lastname: Young
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D002407:Catheterization, Swan-Ganz; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000502:physiology
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain