Neuroendocrine Profiling of Humans Receiving Cardiac Allografts

Autor: Stuart Smith, John P. Veinot, Haissam Haddad, Paul J. Hendry, Kenneth K.-Y. Ma, Randall C. Starling, Tsuneo Ogawa, Mercedes Kuroski de Bold, Ross A. Davies, Roy G. Masters, Kathryn Williams, Adolfo J. de Bold, Amalia Ponce
Rok vydání: 2005
Předmět:
Graft Rejection
Male
Cardiac Catheterization
medicine.medical_treatment
Hemodynamics
p38 Mitogen-Activated Protein Kinases
Cohort Studies
Natriuretic Peptide
Brain
Prospective Studies
Heart transplantation
Graft Survival
Middle Aged
Prognosis
Brain natriuretic peptide
Adrenomedullin
C-Reactive Protein
Echocardiography
cardiovascular system
Cardiology
Female
Tumor necrosis factor alpha
Cardiology and Cardiovascular Medicine
Atrial Natriuretic Factor
hormones
hormone substitutes
and hormone antagonists
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Adolescent
Sensitivity and Specificity
Internal medicine
medicine
Humans
Transplantation
Homologous
cardiovascular diseases
Aged
Monitoring
Physiologic
Probability
Postoperative Care
Analysis of Variance
Transplantation
Interleukin-6
business.industry
Myocardium
Endocrinology
Heart Transplantation
Surgery
Troponin C
business
human activities
Biomarkers
Interleukin-1
Hormone
Blood sampling
Zdroj: The Journal of Heart and Lung Transplantation. 24:1046-1054
ISSN: 1053-2498
DOI: 10.1016/j.healun.2004.06.023
Popis: Background Several studies have investigated changes in circulating hormones and markers of cardiac status after heart transplantation in humans. As a result, plasma levels of various hormones and autocoids have been associated with cardiac allograft rejection status. However, no clear associations can be defined given the highly contradictory nature of the available literature. Methods In this study of 69 consecutive heart transplant patients followed for >2 years we examine the relationship between neurohumors potentially related to allograft rejection and endomyocardial biopsy grade of rejection (according to the ISHLT) and hemodynamic status. Markers assessed include brain natriuretic peptide (BNP), amino-terminal pro-BNP (N-BNP), atrial natriuretic factor (ANF), adrenomedullin, interleukin-1β, interleukin-6, tumor necrosis factor-α, troponin C and C-reactive protein. Results The highest plasma levels for most neurohumors were found shortly after surgery and showed a trend towards normalization with time. BNP and N-BNP were the only significantly elevated plasma analytes for patients with Grade 3 rejection as compared with other ISHLT grades. ANF plasma levels correlated with BNP and N-BNP in Grades 0 to 2, but not in Grade 3, suggesting that in this rejection grade the usual coordinated changes observed in BNP and ANF secretion no longer exist. Cardiac filling pressures were correlated with plasma BNP, N-BNP and ANF levels only for Grades 0 and 1. Conclusions The timing of blood sampling after transplantation influences the level of the neurohumors measured, which may help explain the conflicting literature reports on the association between neurohumor levels and rejection grade. The significant increase in circulating levels of BNP and N-BNP observed in most cases of Grade 3 rejection occurred with no apparent relationship to post-transplantation time, which suggests a specific influence of acute rejection on BNP gene expression.
Databáze: OpenAIRE
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