Avaliação do peptídeo natriurético tipo B no diagnóstico de rejeição após transplante cardíaco pediátrico

Sylos, Cristina de; Azeka, Estela; Kajita, Luiz J.; Benvenutti, Luis; Branco, Klebia Castello; Riso, Arlindo; Tanamati, Carla; Jatene, Marcelo Biscegli; Barbero-Marcial, Miguel

doi:10.1590/s0066-782x2009000300011

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…The diagnosis of rejection is performed by clinical evaluation with noninvasive methods such as clinical symptoms of irritability, fatigue, heart failure, arrhythmias, electrocardiographic and echocardiographic changes. Gallium 67 scintigraphy and BNP (brain natriuretic peptide) have been useful in contributing to confirm the diagnosis [ 7 ] .…”

Section: Discussionmentioning

confidence: 99%

“…In this series, the incidence of this complication was 7.4% in 10 years of follow-up. The increase in BNP, in addition to its already known relationship with rejection, seems to be associated with the occurrence of GVD [ 7 ] . In our department, we have made aggressive attempts to perform coronary angiography and/or coronary angiotomography to have and early diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric and Congenital Heart Transplant: Twenty-year Experience in a Terciary Brazilian Hospital

Miana¹,

Azeka²,

Canêo³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionCardiac transplantation remains the gold standard for end-stage cardiomyopathies and congenital heart defects in pediatric patients.ObjectiveThis study aims to report on 20 years of experience since the first case and evaluate our results.MethodsWe conducted a retrospective analysis of the database and outpatient follow-up. Between October 1992 and April 2012, 109 patients underwent 114 transplants. 51.8% of them being female. The age of patients ranged from 12 days to 21 years with a mean of 8.8±5.7 years and a median of 5.2 years. The underlying diagnosis was dilated cardiomyopathy in 61.5%, congenital heart disease in 26.6% and restrictive cardiomyopathy in 11.9%. All patients above 17 years old had congenital heart disease.ResultsSurvival rate at 30 days, 1, 5, 10, 15, and 20 years were 90.4%, 81.3%, 70.9%, 60.5%, 44.4% and 26.7%, respectively. Mean cold ischemic time was 187.9 minutes and it did not correlate with mortality (P>0.05). Infectious complications and rejection episodes were the most common complications (P<0.0001), occurring, respectively, in 66% and 57.4% of the survivors after 10 years. There was no incidence of graft vascular disease and lymphoproliferative disease at year one, but they affected, respectively, 7.4% and 11% of patients within 10 years.ConclusionTwenty-year pediatric heart transplant results at our institution were quite satisfactory and complication rates were acceptable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pediatric and Congenital Heart Transplant: Twenty-year Experience in a Terciary Brazilian Hospital

Miana¹,

Azeka²,

Canêo³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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Role of BNP in Pediatric Heart Transplantation

Jatene

Azeka

2013

Inflammatory Response in Cardiovascular Surgery

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Mechanisms involved in increased plasma brain natriuretic peptide after heart transplantation

Talha

Charloux

Enache

et al. 2010

Cardiovascular Research

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Increased brain natriuretic peptide (BNP), reflecting increased ventricular wall stress and pressure, is a well-known diagnostic and prognostic marker in patients with chronic heart failure. Heart transplantation (HT), the process of replacing the failing heart and restoring haemodynamics, should normalize cardiac endocrine function. Nevertheless, BNP levels remain raised after HT, likely because of increased secretion and/or decreased clearance of the cardiac hormone. Thus, BNP increases in proportion to the extent of left and right ventricular dysfunction after HT. Clinically complicated cardiac transplantation (cardiac systolic dysfunction, renal failure) is associated with the higher level of circulating BNP, and clinically successful cardiac transplantation (mild cardiac diastolic dysfunction) is associated with moderately increased BNP values. Surprisingly, however, increased BNP has also been found after HT in the absence of haemodynamic perturbations or allograft rejection, raising the hypothesis that even subtle modification in the immune system might influence BNP expression. In view of the potential interest in the cardiac hormone for subjects' risk stratification and therapy, a better knowledge of the mechanisms involved in the BNP increase after HT might be helpful for HT recipients' follow-up.

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Avaliação do peptídeo natriurético tipo B no diagnóstico de rejeição após transplante cardíaco pediátrico

Abstract: SummaryBackground: Rejection is one of the major causes of mortality following pediatric heart transplant. B-type natriuretic peptide (BNP) has been studied as a method for the diagnosis of acute rejection, especially in adult patients undergoing heart transplant.

Cited by 3 publications

References 33 publications

Pediatric and Congenital Heart Transplant: Twenty-year Experience in a Terciary Brazilian Hospital

Pediatric and Congenital Heart Transplant: Twenty-year Experience in a Terciary Brazilian Hospital

Role of BNP in Pediatric Heart Transplantation

Mechanisms involved in increased plasma brain natriuretic peptide after heart transplantation

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