Yonsei Med J.  2008 Aug;49(4):625-631. 10.3349/ymj.2008.49.4.625.

N-terminal Pro B-type Natriuretic Peptide and the Evaluation of Cardiac Dysfunction and Severity of Disease in Cirrhotic Patients

• Woo JJ
• Koh YY
• Kim HJ
• Chung JW
• Chang KS
• Hong SP

• KMID: 1793199
• DOI: http://doi.org/10.3349/ymj.2008.49.4.625

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.

Keyword

N-terminal-proBNP; cirrhosis; cardiac dysfunction

MeSH Terms

Adult
Aged
Electrocardiography
Female
Heart Diseases/*blood/complications/*pathology
Humans
Liver Cirrhosis/*blood/complications/*pathology
Male
Middle Aged
Natriuretic Peptide, Brain/*blood

Figure

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  Fig. 1 Plasma NT-proBNP levels in controls and cirrhotic patients who were divided into a compensated group without ascites (pre-ascitic) and a decompensated group with ascites (ascitic). NS, no significant differences.

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  Fig. 2 Plasma NT-proBNP levels in controls and cirrhotic patients grouped as class A, B, and C according to child-pugh classification. NS, no significant differences.

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