N-terminal Pro B-type Natriuretic Peptide and the Evaluation of Cardiac Dysfunction and Severity of Disease in Cirrhotic Patients.
10.3349/ymj.2008.49.4.625
- Author:
Jeong Joo WOO
1
;
Young Youp KOH
;
Hee Joong KIM
;
Joong Wha CHUNG
;
Kyoung Sig CHANG
;
Soon Pyo HONG
Author Information
1. Department of Radiology, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea. yykoh@chosun.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
N-terminal-proBNP;
cirrhosis;
cardiac dysfunction
- MeSH:
Adult;
Aged;
Electrocardiography;
Female;
Heart Diseases/*blood/complications/*pathology;
Humans;
Liver Cirrhosis/*blood/complications/*pathology;
Male;
Middle Aged;
Natriuretic Peptide, Brain/*blood
- From:Yonsei Medical Journal
2008;49(4):625-631
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Cardiac dysfunction and hyperdynamic systemic circulation may be present in patients with cirrhosis. The purpose of this study was to identify relations between plasma levels of N-terminal-proBNP (NT-proBNP), reflecting early ventricular dysfunction, and the severity of liver disease and cardiac dysfunction in cirrhotic patients. MATERIALS and METHODS: Sixty-three cirrhotic patients and 15 controls (group 1) were enrolled in this study. Plasma levels of NT-proBNP were determined in echocardiographically examined patients, which were allocated to 1 of 3 groups according to Child-Pugh classification or into 2 groups, i.e., a compensated group without ascites (group 2) and decompensated group with ascites (group 3). RESULTS: Plasma NT-proBNP levels were significantly higher in cirrhotic patients (groups 2 and 3) than in age-matched controls (155.9 and 198.3 vs. 40.3pg/mL, respectively, p < 0.05). NT-proBNP levels were significantly increased in Child class C patients than in classes B and A (250.0 vs. 168.6 and 119.6pg/mL, respectively, p < 0.05). Left atrial dimension, wall thickness of left ventricle, and EF or E/E' were significantly increased, and EDT was prolonged in cirrhotic patients than in controls. Increased LVMI and decreased E/A ratio were noted in the group of patients with ascites as compared with the other groups. CONCLUSION: Plasma NT-proBNP levels were high in cirrhotic patients and are likely to be related to the severity of disease. Advanced cirrhosis is associated with advanced cardiac dysfunction, and NT-proBNP levels has predictive value for concomitant cardiac dysfunction and cirrhosis progression.
