Intra-individual changes in brain natriuretic peptide over time may be more helpful than absolute values for detecting right cardiac dysfunction in heart transplant recipients.
Does monitoring intra-individual change in BNP over time improve the detection of right cardiac dysfunction in heart transplant recipients compared to absolute BNP values?
In heart transplant recipients, tracking intra-individual changes in BNP over time may be more clinically useful than absolute values for detecting right ventricular dysfunction.
Heart transplantation (HT) should normalize cardiac endocrine function, but brain natriuretic peptide (BNP) levels remain elevated after HT, even in the absence of left ventricular hemodynamic disturbance or allograft rejection. Right ventricle (RV) abnormalities are common in HT recipients (HTx), as a result of engraftment process, tricuspid insufficiency, and/or repeated inflammation due to iterative endomyocardial biopsies. RV function follow-up is vital for patient management as RV dysfunction is a recognized cause of in-hospital death and is responsible for a worse prognosis. Interestingly, few and controversial data are available concerning the relationship between plasma BNP levels and RV functional impairment in HTx. This suggests that infra-clinical modifications, such as subtle immune system disorders or hypoxic conditions, might influence BNP expression. Nevertheless, due to other altered circulating molecular forms of BNP, a lack of specificity of BNP assays is described in heart failure patients. This phenomenon could exist in HT population and could explain elevated BNP plasmatic levels despite a normal RV function. In clinical practice, intra-individual change in BNP over time, rather than absolute BNP values, might be more helpful in detecting right cardiac dysfunction in HTx.
Talha et al. (Fri,) conducted a review in Right heart dysfunction after heart transplantation. Brain natriuretic peptide (BNP) monitoring was evaluated. Intra-individual changes in brain natriuretic peptide over time may be more helpful than absolute values for detecting right cardiac dysfunction in heart transplant recipients.