title: B-type natriuretic peptide as a marker of allograft rejection after heart transplantation.
abstract: B-type natriuretic peptide (BNP) concentrations, a cardiac hormone released upon cardiac stress, was monitored in patients after heart transplantation. Rejection was assessed by the International Society for Heart and Lung Transplantation (ISHLT) criteria. BNP was assessed by a cross-sectional approach. We found significantly (p = 0.024) increased concentrations during rejection episodes of ISHLT grade 2 and higher. BNP yielded only a moderate diagnostic accuracy (area under the receiving characteristic curve: mean = 0.76, 95% confidence interval 0.53-0.92) to detect clinically significant episodes of rejection, which was too low to replace endomyocardial biopsies. Acute rejection episodes were associated with marked BNP increases and a significant decrease in case of successful treatment in the individual long-term monitoring in the majority of patients. BNP monitoring seems to be a useful addition in the individual follow-up of heart transplant recipients to rule out significant rejection.
authors.affiliation: Department of Medical Chemistry and Biochemistry, Division of Clinical Biochemistry, Innsbruck Medical University, Innsbruck, Austria. Angelika.Lercher@uibk.ac.at
authors.forename: Angelika
authors.initials: A
authors.lastname: Hammerer-Lercher
authors.forename: Johannes
authors.initials: J
authors.lastname: Mair
authors.forename: Herwig
authors.initials: H
authors.lastname: Antretter
authors.forename: Elfriede
authors.initials: E
authors.lastname: Ruttmann
authors.forename: Gerhard
authors.initials: G
authors.lastname: Poelzl
authors.forename: Günther
authors.initials: G
authors.lastname: Laufer
authors.forename: Bernd
authors.initials: B
authors.lastname: Puschendorf
authors.forename: Herbert
authors.initials: H
authors.lastname: Hangler
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000517:prevention & control; D006084:Graft Rejection / Q000175:diagnosis*; D016027:Heart Transplantation; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain