N-terminal pro-beta-type natriuretic peptide (NT-proBNP) can be considered a valuable predictor of heart rejection

Background: N-terminal pro-beta-type natriuretic peptide (NT-proBNP) is now used in the diagnosis of heart failure; nevertheless, there is still no expert consensus regarding its value in detecting rejection. This paper therefore aims to examine the role of NT-proBNP in detecting rejection at earlier asymptomatic stages. Methods: This study was designed as a single-center prospective trial on 70 heart recipients, all 50 years old or younger between March 2012 and June 2014 at the Imam Khomeini Hospital Complex, Tehran University. In recipients showing any evidence of heart failure or even asymptomatic recipients with high serum level of NT-proBNP (≥450 pg/ml under age 50) or decreased LVEF, an endomyocardial biopsy (EMB) was carried out. Results: Statistically significant correlation was found between rise in serum level of NT-proBNP and biopsy results (p = 0.024). Correlation was found also between serum level of NT-proBNP before and after treatment of rejection (p = 0.03). Even with an obvious rise in the serum level of NT-proBNP, there was no evidence of any simultaneous significant change in LVEF. Conclusions: We showed that NT-proBNP can be used as a valuable biomarker to detect rejection in earlier asymptomatic stages to prevent further rejection progression and its bad consequences; however, it needs further multicenter studies. © 2015, Indian Association of Cardiovascular-Thoracic Surgeons.