B-type natriuretic peptide is related to cardiac function and prognosis in hospitalized patients with decompensated cirrhosis

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Pimenta J (Author) FMUP; Paulo, C (Author) Other; Gomes, A (Author) Other; Silva, S (Author) Other; Rocha Goncalves, F (Author) Other; Bettencourt P (Author) FMUP

Journal

Title: Liver International

Vol. 30 No. 7

Pages: 1059-1066

ISSN: 1478-3223

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 35 Citations

Scopus - 32 Citations

Scientific classification

FOS: Medical and Health sciences > Other medical sciences

Other information

Authenticus ID: P-003-4GF

DOI: 10.1111/j.1478-3231.2010.02266.x

Abstract (EN): Background: B-type natriuretic peptide (BNP) concentrations are high in cirrhosis, possibly related to volume status and cirrhotic cardiomyopathy. The prognostic significance of BNP in cirrhosis is unknown. Aims: We aimed to evaluate (i) the influence of haemodynamic parameters and volaemia, assessed by impedance cardiography (ICG), in BNP levels, (ii) the performance of BNP as a prognostic marker, in a cohort of cirrhotic patients. Methods: Patients consecutively hospitalized with decompensated cirrhosis during 1 year were evaluated. At admission, ICG and BNP measurements were performed in 83 patients (median age 56 years; median Child-Pugh score = 10). The 70 patients discharged were followed for the occurrence of death within 6 months. Results: Median BNP levels were 130.3 (65.2-363.3) pg/ml. Independent BNP predictors in multivariate linear regression analysis were cardiac output, age and haemoglobin (R(2) = 36.7%). The 24 patients with cardiac systolic dysfunction, defined by low cardiac output, had higher BNP concentrations than the other patients (230.8 vs 98.5 pg/ml, P = 0.003). BNP levels above median were associated with an increased occurrence of death within 6 months of discharge (log rank P = 0.023). Cardiac output and BNP were predictors of survival in univariate Cox regression analysis. Only BNP remained independently related to the outcome in multivariate analysis [hazard ratio = 2.86 (1.11-7.38), P = 0.03]. Conclusions: BNP levels in cirrhosis reflect cardiac systolic function and non-cardiac variables that should be considered in their interpretation. BNP is an independent predictor of medium-term survival in advanced cirrhosis, suggesting its utility in risk stratification of decompensated cirrhotic patients.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8