Brain natriuretic peptide (BNP) as a biomarker of myocardial ischemia-reperfusion injury in cardiac transplantation.
OBJECTIVE
To evaluate brain natriuretic peptide (BNP) as a biomarker of ischemia-reperfusion injury in cardiac transplantation


METHODS
A prospective cohort study.


METHODS
A single academic medical center.


METHODS
Adult patients undergoing orthotopic cardiac transplantation (n = 25).


METHODS
None.


RESULTS
The authors performed serial measurements of BNP and troponin-I in cardiac allograft donors and recipients, determining the relationship between these biomarkers and established risk factors for and measures of early graft dysfunction. Postoperative BNP correlated moderately with allograft ischemic time (ρ = 0.52, p = 0.01), donor BNP (ρ = 0.45, p = 0.03), and donor troponin-I (ρ = 0.49, p = 0.01). Postoperative BNP was higher in patients with persistently elevated inotrope requirements and enabled the early identification of such patients. In contrast, there was no association between postoperative troponin-I and these same parameters.


CONCLUSIONS
Postoperative BNP is associated with preimplantation and clinical performance parameters related to allograft ischemia-reperfusion injury at the time of cardiac transplantation, providing preliminary evidence to support its potential use as an ischemia-reperfusion injury biomarker in this context.
McIlroy
David R
DR
Department of Anesthesiology, Columbia-Presbyterian Medical Center, New York, NY 10032, USA. dm2655@columbia.edu
Wallace
Sophie
S
Roubos
Nicholas
N
D000328:Adult; D000758:Anesthesia; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use
D015415:Biomarkers; D002316:Cardiotonic Agents; D019210:Troponin I; D014662:Vasoconstrictor Agents; D020097:Natriuretic Peptide, Brain; D004837:Epinephrine