Is There a Correlation Between Brain Naturietic Peptide Levels and Echocardiographic and Hemodynamic Parameters in Heart Transplant Patients? L. Almenar, M.A. Arnau, L. Martı´nez-Dolz, I. Hervás, A. Osa, V. Miró, E. Sánchez, E. Zorio, J. Rueda, A. Mateo, and A. Salvador ABSTRACT Background. Brain naturietic peptide (BNP) elevations have been reported in heart transplant patients both at baseline and during rejection. An association between BNP levels and certain echocardiographic and hemodynamic abnormalities has also been found in nontransplanted heart disease patients. We sought to determine whether BNP values were correlated with echocardiographic and hemodynamic parameters among a large cohort of heart transplant patients. Materials and methods. We studied 71 consecutive heart transplant patients, excluding combined grafts, retransplants, and pediatric cases. We performed 488 BNP determina- tions during catheterization and within 48 hours of echocardiography. Hemodynamic parameters included mean pulmonary artery pressure, right ventricular systolic and diastolic pressures. Doppler echocardiography parameters were wall thickness, ventricular mass, left and right ventricular end-diastolic and end-systolic diameters, isovolumic relaxation time, and mitral flow deceleration time. Results. We observed significant correlations between BNP values and left ventricular size, ventricular mass, and a restrictive filling pattern. BNP levels were also significantly correlated with right ventricular size, mean pulmonary artery pressure, and right ventric- ular diastolic and end-diastolic pressures. Conclusions. In heart transplant patients, BNP levels positively correlated with ventric- ular diameters and a restrictive filling pattern. An increase in right ventricle and pulmonary artery pressures was associated with elevated BNP values. B RAIN NATURIETIC PEPTIDE (BNP) is a cardiac hormone, which is secreted in response to myocardial stress, producing vasodilatory and diuretic effects. It has high diagnostic value in heart failure and is also prognostic; increased values are associated with an increased risk of cardiovascular complications and death from cardiac causes. 1 In heart failure patients, a restrictive filling pattern of transmitral flow is associated with elevated BNP values. 2 Elevated pulmonary artery and/or ventricular pressures (end-diastolic pressure) may also be accompanied by in- creased secretion of this hormone. 3 The aim of the present study was to assess whether the pathophysiological behavior of the transplanted heart was similar to the native heart in terms of the association between BNP values, filling pat- tern, and pulmonary artery pressures. MATERIALS AND METHODS We examined samples from 71 consecutively transplanted patients over a period of 3 years excluding retransplants, heart-lung trans- plants, and pediatric cases. A total of 488 BNP determinations were made at the time of catheterization and within 48 hours of the echocardiographic study. BNP was determined by a radioimmuno- metric assay, with normal values of 18 pg/mL provided by the kit manufacturer (Shionora BNP Cis Bio International, Cedes, France). Pearson’s two-tailed correlation coefficient was calculated From the Departments of Cardiology (L.A., M.A.A., L.M.-D., A.O., V.M., E.S., E.Z., J.R., A.S.) and Nuclear Medicine (I.H., A.M.), “La Fe” University Hospital, Valencia, Spain. Address reprint requests to Dr Luis Almenar Bonet, Avd Primado Reig 189-37, 46020 Valencia, Spain. E-mail: lu.almenarb5@ comv.es 0041-1345/06/$–see front matter © 2006 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2006.08.082 360 Park Avenue South, New York, NY 10010-1710 2534 Transplantation Proceedings, 38, 2534 –2536 (2006)