Clinical Investigation of pro-BNP in Hepatic Cirrhosis Patients in an Emergency Department

Lee, Suk Woo; Kim, Hoon; Park, Jung Soo

Abstract

PURPOSE: Cardiac dysfunction may be present in patients with hepatic cirrhosis. This study was performed to evaluate the plasma concentration of pro Brain Natriuretic Peptide (pro-BNP), a marker of severity of hepatic cirrhosis and cardiac dysfunction.
METHODS
We retrospectively analyzed the medical records of 85 patients who had been diagnosed with hepatic cirrhosis and admitted through the emergency department. Circulating levels of pro-BNP, Child-Pugh class and Sequential Organ Failure Assessment (SOFA) score were determined.
RESULTS
Plasma pro-BNP levels were significantly increased in cirrhotic patients with ascites or heart failure (p=0.000, p=0.000, respectively) but not in patients with encephalopathy or gastrointestinal bleeding (p=0.396, p=0.059, respectively). Circulating pro-BNP levels were closely correlated with SOFA scores (r=0.331, p=0.002) and correlated with Modified Child-Pugh classification scores (r=0.273, p=0.033). The SOFA score is an easily applied tool with good prognostic abilities, but pro-BNP and Child-Pugh class can also be used to enhance clinical judgment of prognosis.
CONCLUSION
Increased pro-BNP levels are likely related to the severity of disease in hepatic cirrhosis. Advanced cirrhosis is associated with advanced cardiac dysfunction and pro-BNP has prognostic value for cirrhosis.