Brain Natriuretic Peptide (BNP) as a Biomarker of Myocardial Ischemia-Reperfusion Injury in Cardiac Transplantation

ObjectivesTo evaluate brain natriuretic peptide (BNP) as a biomarker of ischemia-reperfusion injury in cardiac transplantationDesignA prospective cohort study.SettingA single academic medical center.ParticipantsAdult patients undergoing orthotopic cardiac transplantation (n = 25).InterventionsNone.Measurements and Main ResultsThe authors performed serial measurements of BNP and troponin-I in cardiac allograft donors and recipients, determining the relationship between these biomarkers and established risk factors for and measures of early graft dysfunction. Postoperative BNP correlated moderately with allograft ischemic time (ρ = 0.52, p = 0.01), donor BNP (ρ = 0.45, p = 0.03), and donor troponin-I (ρ = 0.49, p = 0.01). Postoperative BNP was higher in patients with persistently elevated inotrope requirements and enabled the early identification of such patients. In contrast, there was no association between postoperative troponin-I and these same parameters.ConclusionsPostoperative BNP is associated with preimplantation and clinical performance parameters related to allograft ischemia-reperfusion injury at the time of cardiac transplantation, providing preliminary evidence to support its potential use as an ischemia-reperfusion injury biomarker in this context.