B-type Natriuretic Peptide Is a Sensitive Screening Test for Acute Rejection in Pediatric Heart Transplant Patients

Rossano, Joseph W.; Denfield, Susan W.; Kim, Jeffrey; Price, Jack F.; Jefferies, John L.; Decker, Jamie A.; Smith, E. O’Brian; Clunie, Sarah K.; Towbin, Jeffrey A.; Dreyer, William J.

doi:10.1016/j.healun.2008.03.008

Cited by 41 publications

(35 citation statements)

References 38 publications

(32 reference statements)

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“…Others also have reported more recently an association between plasma BNP and cardiac cellular rejection [28–31]. Similar findings were seen in pediatric cardiac allograft recipients [32, 33]. Finally, plasma BNP or NT-proBNP levels in postcardiac transplantation strongly and independently predicted cardiac mortality [34, 35].…”

Section: Plasma Bnp In Acute Cardiac Allograft Rejectionsupporting

confidence: 54%

Brain Natriuretic Peptide Production and Secretion in Inflammation

Ogawa

Bold

2012

Journal of Transplantation

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Gene expression and secretion of the cardiac polypeptide hormones atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP) are simultaneously upregulated in various cardiac disorders such as congestive heart failure, ischemic heart disease, and hypertensive heart disease, in which hemodynamic or neuroendocrine changes are key components in the progression of disease. However, during acute cardiac allograft rejection, plasma BNP levels are increased but not those of ANF. Successful treatment of the rejection episode decreases the elevated plasma BNP to prerejection values suggesting that substances related to inflammation may selectively influence BNP gene expression. Indeed, cytokines such as TNFα and IL-1β selectively stimulate cardiac BNP at the transcriptional and translational levels in cardiomyocyte cultures without affecting ANF. This selective BNP increase is seen in vivo, in addition to acute cardiac allograft rejection, in several circumstances where inflammation significantly contributes to the pathogenesis of disease such as in sepsis and in acute myocarditis.

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Section: Plasma Bnp In Acute Cardiac Allograft Rejectionsupporting

confidence: 54%

Brain Natriuretic Peptide Production and Secretion in Inflammation

Ogawa

Bold

2012

Journal of Transplantation

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“…Lan et al[28] (2004 showed that BNP was elevated early on after heart transplantation however, falls exponentially early on and reached very low levels around 3 mo post-transplant. Lindblade et al[29] and Rossano et al[30] showed that BNP was significant elevated in acute rejection and had sensitivities of 96% with BNP > 100 pg/mL 1 year after transplantation. Sparks et al[31] have documented reduction in BNP over the first 3 mo and showed correlation it with hemodynamics.…”

Section: B-type Natriuretic Peptide and N-terminal Segment Of Pro-b-tmentioning

confidence: 99%

Cardiac biomarkers in pediatric heart disease: A state of art review

Fernandes¹,

Maher²,

Deshpande³

2016

WJC

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Every year there are more than 11000 hospitalizations related to heart failure in children resulting in significant morbidity and mortality. Over the last two decades, our understanding, diagnosis and management of pediatric heart failure is evolving but our ability to prognosticate outcomes in pediatric heart acute heart failure is extremely limited due to lack of data. In adult heart failure patients, the role of cardiac biomarkers has exponentially increased over the last two decades. Current guidelines for management of heart failure emphasize the role of cardiac biomarkers in diagnosis, management and prognostication of heart failure. It is also noteworthy that these biomarkers reflect important biological processes that also open up the possibility of therapeutic targets. There is however, a significant gap present in the pediatric population with regards to biomarkers in pediatric heart failure. Here, we seek to review available data regarding cardiac biomarkers in the pediatric population and also explore some of the emerging biomarkers from adult literature that may be pertinent to pediatric heart failure.

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“…BNP levels have high sensitivity and NPV for acute rejection in pediatric heart transplant patients. In 86 that patients underwent a total of 560 endomyocardial biopsies in patients > 1 year post-transplant, a BNP level of < 100 pg/mL correlated with a < 1% chance of aortic regurgitation (AR) and may obviate the need for biopsies in some cases 31. In an observational study that included 71 heart transplant patients, the increase between the two serial determinations of BNP levels at the end of the first year post-transplant indicated a subgroup of patients with a poorer outcome 32…”

Section: Cardiac Diseasesmentioning

confidence: 99%

Interpretation and Use of Natriuretic Peptides in Non-Congestive Heart Failure Settings

et al. 2010

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Natriuretic peptides (NPs) have been found to be useful markers in differentiating acute dyspneic patients presenting to the emergency department (ED) and emerged as potent prognostic markers for patients with congestive heart failure (CHF). The best-established and widely used clinical application of BNP and NT-proBNP testing is for the emergent diagnosis of CHF in patients presenting with acute dyspnea. Nevertheless, elevated NPs levels can be found in many circumstances involving left ventricular (LV) dysfunction or hypertrophy; right ventricular (RV) dysfunction secondary to pulmonary diseases; cardiac inflammatory or infectious diseases; endocrinology diseases and high output status without decreased LV ejection fraction. Even in the absence of significant clinical evidence of volume overload or LV dysfunction, markedly elevated NP levels can be found in patients with multiple comorbidities with a certain degree of prognostic value. Potential clinical applications of NPs are expanded accompanied by emerging reports regarding screening the presence of secondary cardiac dysfunction; monitoring the therapeutic responses, risk stratifications and providing prognostic values in many settings. Clinicians need to have expanded knowledge regarding the interpretation of elevated NPs levels and potential clinical applications of NPs. Clinicians should recognize that currently the only reasonable application for routine practice is limited to differentiation of acute dyspnea, rule-out-diagnostic-tests, monitoring of therapeutic responses and prognosis of acute or decompensated CHF. The rationales as well the potential applications of NPs in these settings are discussed in this review article.

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B-type Natriuretic Peptide Is a Sensitive Screening Test for Acute Rejection in Pediatric Heart Transplant Patients

Cited by 41 publications

References 38 publications

Brain Natriuretic Peptide Production and Secretion in Inflammation

Brain Natriuretic Peptide Production and Secretion in Inflammation

Cardiac biomarkers in pediatric heart disease: A state of art review

Interpretation and Use of Natriuretic Peptides in Non-Congestive Heart Failure Settings

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