Increased circulating pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP) in patients with cirrhosis: relation to cardiovascular dysfunction and severity of disease
Background and aims: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides reflecting early ventricular dysfunction (pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP)) to markers of severi...
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Published in | Gut Vol. 52; no. 10; pp. 1511 - 1517 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
England
BMJ Publishing Group Ltd and British Society of Gastroenterology
01.10.2003
BMJ Publishing Group LTD Copyright 2003 by Gut |
Subjects | |
Online Access | Get full text |
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Summary: | Background and aims: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides reflecting early ventricular dysfunction (pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP)) to markers of severity of liver disease, cardiac dysfunction, and hyperdynamic circulation in patients with cirrhosis. Patients and methods: Circulating levels of proBNP and BNP were determined in 51 cirrhotic patients during a haemodynamic investigation. Results: Plasma proBNP and BNP were significantly increased in cirrhotic patients (19 and 12 pmol/l, respectively) compared with age matched controls (14 and 6 pmol/l; p<0.02) and healthy subjects (<15 and <5.3 pmol/l; p<0.002). Circulating proBNP and BNP were closely correlated (r = 0.89, p<0.001), and the concentration ratio proBNP/BNP was similar to that of control subjects (1.8 v 2.3; NS). Circulating proBNP and BNP were related to severity of liver disease (Child score, serum albumin, coagulation factors 2, 7, and 10, and hepatic venous pressure gradient) and to markers of cardiac dysfunction (QT interval, heart rate, plasma volume) but not to indicators of the hyperdynamic circulation. Moreover, in multiple regression analysis, proBNP and BNP were also related to arterial carbon dioxide and oxygen tensions. The rate of hepatic disposal of proBNP and BNP was not significantly different in cirrhotic patients and controls. Conclusion: Elevated circulating levels of proBNP and BNP in patients with cirrhosis most likely reflects increased cardiac ventricular generation of these peptides and thus indicates the presence of cardiac dysfunction, rather than being caused by the hyperdynamic circulatory changes found in these patients. |
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Bibliography: | PMID:12970147 ark:/67375/NVC-S5MDJZN0-T Correspondence to: Professor J H Henriksen, Department of Clinical Physiology, 239, Hvidovre Hospital/University of Copenhagen, DK-2650 Hvidovre, Denmark; jens.h.henriksen@hh.hosp.dk local:0521511 istex:EC4290BE7F35E05B3C8D2348F3AD8C18E0F8D22E href:gutjnl-52-1511.pdf ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Correspondence to: Professor J H Henriksen, Department of Clinical Physiology, 239, Hvidovre Hospital/University of Copenhagen, DK-2650 Hvidovre, Denmark; jens.h.henriksen@hh.hosp.dk |
ISSN: | 0017-5749 1468-3288 1458-3288 |
DOI: | 10.1136/gut.52.10.1511 |