The Investigation of Endomyocardial Biopsy Results, Plasma pro-BNP Levels and Non-invasive Parameters for Diagnosing of Acute Rejection in Patients Who Undergo Cardiac Transplantation

Abstract

Aim: Heart failure is a disease with high mortality and morbidity, reducing the patient's quality of life. Each year 10% of heart failure patients progress to end-stage heart failure. Cardiac transplantation is the gold standard treatment method in these patients, however acute rejection is the most important factor affecting the success of this treatment. In this study, it was aimed to evaluate endomyocardial biopsy results, serum pro-BNP and non-invasive parameters in patients with acute rejection following cardiac transplantation.Patients and Methods: Twenty patients who underwent cardiac transplantation in our center were included in the study. The patients were divided into two groups, namely acute rejection (n: 10) and without rejection (n: 10). Echocardiography, electrocardiography (ECG), endomyocardial biopsy results, serum reactive proteins (CRP), sedimentation rate and serum pro-BNP levels, were evaluated among the patients and compared between the groups.Results: Endomyocardial biopsies obtained from patients with acute rejection revealed grade 1 rejection in 6 (60%) patients, grade 2 in 3 (30%) patients and grade 3 rejection in 1 (10%) patients. CRP and sedimentation rate were found to be similar between the groups (p> 0.05). High pro-BNP levels were found in patients with rejection (4843.20 ± 6690.10 pg / ml) when compared to the control group (496.30± 216.20 pg / ml) (p: 0.001). In addition, higher pro-BNP levels were detected with progressing of rejection grade (p: 0.03). The highest pro-BNP level was found in a patient with Grade-3 rejection (15211 pg / ml, p: 0.000).Conclusion: Our results show that serum pro-BNP levels are associated with acute rejection. In addition, higher pro-BNP levels were found to be associated with advanced rejection levels.