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 |
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England
BMJ Publishing Group Ltd and British Society of Gastroenterology
01.10.2003
BMJ Publishing Group LTD Copyright 2003 by Gut |
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Abstract | 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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AbstractList | 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.
Circulating levels of proBNP and BNP were determined in 51 cirrhotic patients during a haemodynamic investigation.
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.
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. 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. 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. BACKGROUND AND AIMSCardiac 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 METHODSCirculating levels of proBNP and BNP were determined in 51 cirrhotic patients during a haemodynamic investigation.RESULTSPlasma 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.CONCLUSIONElevated 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. |
Author | Christensen, E Henriksen, J H Fuglsang, S Bendtsen, F Gøtze, J P Møller, S |
AuthorAffiliation | 3 Department of Medicine I, Bispebjerg Hospital, Unversity of Copenhagen, Copenhagen, Denmark 4 Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark 2 Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark 1 Department of Clinical Physiology, 239, Hvidovre Hospital, Hvidovre, Denmark |
AuthorAffiliation_xml | – name: 1 Department of Clinical Physiology, 239, Hvidovre Hospital, Hvidovre, Denmark – name: 3 Department of Medicine I, Bispebjerg Hospital, Unversity of Copenhagen, Copenhagen, Denmark – name: 4 Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark – name: 2 Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark |
Author_xml | – sequence: 1 givenname: J H surname: Henriksen fullname: Henriksen, J H organization: Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark – sequence: 2 givenname: J P surname: Gøtze fullname: Gøtze, J P organization: Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark – sequence: 3 givenname: S surname: Fuglsang fullname: Fuglsang, S organization: Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark – sequence: 4 givenname: E surname: Christensen fullname: Christensen, E organization: Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark – sequence: 5 givenname: F surname: Bendtsen fullname: Bendtsen, F organization: Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark – sequence: 6 givenname: S surname: Møller fullname: Møller, S organization: Department of Gastroenterology, 439, Hvidovre Hospital, Hvidovre, Denmark |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/12970147$$D View this record in MEDLINE/PubMed |
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Notes | 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 |
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Snippet | Background and aims: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac... Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides reflecting early... BACKGROUND AND AIMSCardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides... Background and aims: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac... |
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SubjectTerms | Adult Aged ANP Ascites atrial natriuretic peptide Blood pressure BNP brain natriuretic peptide Carbon Dioxide - blood cardiac dysfunction cardiac ventricular peptides Cardiovascular Diseases - blood Cardiovascular Diseases - etiology Case-Control Studies Catheters cirrhotic cardiomyopathy Diuretics Female Heart rate Hemodynamics Humans Liver Liver cirrhosis Liver Cirrhosis - blood Liver Cirrhosis - complications Liver diseases Male Middle Aged Natriuretic Peptide, Brain - blood Nerve Tissue Proteins - blood Oxygen - blood Peptide Fragments - blood Peptides pro-brain natriuretic peptide proBNP QT interval Regression Analysis |
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Title | Increased circulating pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP) in patients with cirrhosis: relation to cardiovascular dysfunction and severity of disease |
URI | http://dx.doi.org/10.1136/gut.52.10.1511 https://api.istex.fr/ark:/67375/NVC-S5MDJZN0-T/fulltext.pdf https://www.ncbi.nlm.nih.gov/pubmed/12970147 https://www.proquest.com/docview/1779321374/abstract/ https://search.proquest.com/docview/73641321 https://pubmed.ncbi.nlm.nih.gov/PMC1773816 |
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