Document Detail


BNP as marker of heart dysfunction in patients with liver cirrhosis.
MedLine Citation:
PMID:  20729741     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUNDS: Patients with liver cirrhosis suffer various degrees of cardiac dysfunction which may be crucial in determining the outcome of surgery. The aim of this study was to determine the role of natriuretic peptides on the assessment of cardiac dysfunction in patients with liver cirrhosis.
METHODS: Prospective longitudinal study of 30 patients with hepatic cirrhosis. Severity of disease was assessed according to the Child-Turcotte-Pugh and Model for End Stage Liver Disease (MELD) scores. Cardiac function was assessed using endocrine markers [atrial natriuretic peptide-brain natriuretic peptide (BNP)] and isotopic ventriculography at baseline and after stimulation with dobutamine.
RESULTS: The ejection fraction was higher in patients with Child A+B and MELD less than 18 than in patients with advanced liver disease. A significant correlation between BNP plasma levels and MELD values was observed. Dobutamine induced a marked improvement in myocardial performance associated to a decrease in BNP levels. Multivariate analysis showed that BNP has prognostic value as a marker of cardiac ejection fraction. Patients whose baseline BNP concentrations were more than 70 pg/ml had an ejection fraction of around 45%.
CONCLUSION: This study has shown that increased baseline BNP concentrations may be regarded together with high Child and MELD scores, as the critical cardiac dysfunction threshold in cirrhotic patients.
Authors:
Javier Padillo; Pilar Rioja; María C Muñoz-Villanueva; Juan A Vallejo; Rubén Ciria; Jordi Muntane; Antonio Sitges-Serra; Guillermo Solórzano; Manuel De la Mata
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  22     ISSN:  1473-5687     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-15     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1331-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Virgen del Rocío University Hospital-IBiS, Sevilla, Spain. javierpadiruiz@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Natriuretic Factor / blood
Biological Markers / blood
Blood Pressure
Dobutamine / diagnostic use
Female
Heart Diseases / blood,  diagnosis,  etiology*,  physiopathology
Heart Rate
Humans
Liver Cirrhosis / blood,  complications*,  physiopathology
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood*
Predictive Value of Tests
Prospective Studies
Radionuclide Ventriculography
Severity of Illness Index
Spain
Stroke Volume
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain; 34368-04-2/Dobutamine; 85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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