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肝移植肝硬化患者的心脏血流动力学特征及B型利钠肽原

Cardiac hemodynamic profiles and pro-B-type natriuretic Peptide in cirrhotic patients undergoing liver transplantation.

作者信息

Bernal V, Pascual I, Esquivias P, García-Gil A, Fernández C, Mateo J M, González M, Simón M A

机构信息

Liver Transplant Unit, University Hospital "Lozano Blesa," Zaragoza, Spain.

出版信息

Transplant Proc. 2009 Apr;41(3):985-6. doi: 10.1016/j.transproceed.2009.02.020.

Abstract

BACKGROUND

The aim of our study was to determine concentrations of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with cirrhosis, thereby describing the hemodynamic and cardiac profiles to verify the existence of cirrhotic cardiomyopathy.

METHODS

Clinical data, NT-proBNP levels, echocardiography, and right heart hemodynamic measurements were performed on all patients undergoing liver transplantation for cirrhosis.

RESULTS

Our patients showed a hyperdynamic circulation with elevated left-sided pressures despite high cardiac outputs. This observation suggested abnormalities in left ventricular diastolic compliance. We verified these results, because our cohort showed a significant left ventricular mass index and, consequently, diastolic dysfunction. Mean NT-proBNP levels were high. The great expansion of central volume may explain these results and the later development of left ventricular hypertrophy.

CONCLUSION

We concluded that elevated concentrations of NT-proBNP indicated the presence of hyperdynamic syndrome and cardiac dysfunction.

摘要

背景

我们研究的目的是测定肝硬化患者氨基末端B型利钠肽原(NT-proBNP)的浓度,从而描述血流动力学和心脏情况,以证实肝硬化性心肌病的存在。

方法

对所有因肝硬化接受肝移植的患者进行临床资料、NT-proBNP水平、超声心动图及右心血流动力学测量。

结果

尽管心输出量高,但我们的患者表现为高动力循环且左侧压力升高。这一观察结果提示左心室舒张顺应性异常。我们证实了这些结果,因为我们的队列显示左心室质量指数显著升高,进而出现舒张功能障碍。NT-proBNP平均水平较高。中心血容量的大幅增加可能解释了这些结果以及随后左心室肥厚的发生。

结论

我们得出结论,NT-proBNP浓度升高表明存在高动力综合征和心脏功能障碍。

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