B-type natriuretic peptide (BNP) has emerged as an important marker of ventricular wall stress and is predictive of hemodynamic abnormalities in heart transplantation. In this study, we aimed to show the clinical value of BNP for stratification and treatment of congestive heart failure in heart transplant recipients and also to determine the correlation of BNP levels at rest and after effort.
Between 2003 and 2006 we have performed 9 heart transplantations in our clinic. Seven patients were enrolled in this study. Blood samples were taken from the patients during the rest and after the effort. In the follow up time transthoracic chocardiography was performed to assess the systolic (ejection fraction) and diastolic function. There were one female and 6 male patients. The mean age was 34.2 ± 10.7 years (7-44). The mean follow up time was 11 ± 9.97 (2-27) months. The mean and median BNP levels at rest were 169.5 pg/dl and 66.3 pg/dl respectively. The mean and median BNP levels at effort were 405.6 pg/dl and 101 pg/dl respectively. One patient were treated due to congestive heart failure. In that patient BNP levels at rest and after exercise were 742 pg/dl and 2040 pg/dl repectively. Echocardiography or right heart catherization are accepted as definitive diagnostic methods for detecting allograft dysfunction. However, these methods may not reflect early structural changes and neurohormonal aberrations involved in allograft dysfunction. We believe that B-type natriuretic peptide may be used to predict congestive heart failure after heart transplantations.