B-type natriuretic peptide is related to cardiac function and prognosis in hospitalized patients with decompensated cirrhosis
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2010 |
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| Erschienen: |
2010 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Liver international : official journal of the International Association for the Study of the Liver - 30(2010), 7 vom: 01. Aug., Seite 1059-66 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pimenta, Joana [VerfasserIn] |
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| Links: |
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| Themen: |
114471-18-0 |
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| Anmerkungen: |
Date Completed 02.11.2010 Date Revised 19.11.2015 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/j.1478-3231.2010.02266.x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM198299028 |
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| 100 | 1 | |a Pimenta, Joana |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a B-type natriuretic peptide is related to cardiac function and prognosis in hospitalized patients with decompensated cirrhosis |
| 264 | 1 | |c 2010 | |
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| 500 | |a Date Completed 02.11.2010 | ||
| 500 | |a Date Revised 19.11.2015 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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] | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Hemoglobins |2 NLM | |
| 650 | 7 | |a Natriuretic Peptide, Brain |2 NLM | |
| 650 | 7 | |a 114471-18-0 |2 NLM | |
| 700 | 1 | |a Paulo, Cristiana |e verfasserin |4 aut | |
| 700 | 1 | |a Gomes, André |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Sérgio |e verfasserin |4 aut | |
| 700 | 1 | |a Rocha-Gonçalves, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Bettencourt, Paulo |e verfasserin |4 aut | |
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