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

• Published in: Yonsei medical journal Vol. 49; no. 4; pp. 625 - 631
• Main Authors: Woo, Jeong Joo, Koh, Young Youp, Kim, Hee Joong, Chung, Joong Wha, Chang, Kyoung Sig, Hong, Soon Pyo
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 30.08.2008; 연세대학교의과대학
• Subjects: Adult; Aged; Electrocardiography; Female; Heart Diseases - blood; Heart Diseases - complications; Heart Diseases - pathology; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Cirrhosis - pathology; Male; Middle Aged; Natriuretic Peptide, Brain - blood; Original; 의학일반
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2008.49.4.625

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. 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). 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. 40.3 pg/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 119.6 pg/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. 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.