Singh Ajmera Jail, Wyawahare Mukta, Sarin Krishna, Rajendiran Soundravally, Subrahmanyam Dharanipragada K S, Satheesh Santhosh
Department of Medicine, JIPMER, Puducherry, India.
Department of Biochemistry, Puducherry, India.
Adv Biomed Res. 2020 Oct 30;9:55. doi: 10.4103/abr.abr_250_19. eCollection 2020.
Liver cirrhosis is associated with cardiac dysfunction in 40%-60% of the patients. Serum NT-ProBNP is a potential additional marker of cirrhotic cardiomyopathy.
It was a cross-sectional analytical study done in a tertiary care center in South India on 100 patients of cirrhosis of liver. Diastolic function was assessed from mitral inflow parameters as well as tissue Doppler imaging of the left ventricle in 95 patients. Serum NT-ProBNP levels was measured once at the time of inclusion into the study. Cirrhotic cardiomyopathy was diagnosed in those with abnormal echocardiographic parameters and its association with NT-Pro BNP levels was analyzed. Data were analyzed using SPSS version 22.
Diastolic dysfunction was found in 40 (42.1%) participants. Twenty-two (23.2%) had Grade I, 16 (16.8%) had Grade II, and 2 (2.1%) had Grade III diastolic dysfunction. The mean NT-Pro-BNP was elevated (107.38 [±66.76] ng/ml) in patients with diastolic dysfunction. NT-ProBNP was higher in Child-Pugh B and C disease when compared to milder disease. NT-ProBNP was not a good screening tool for cardiomyopathy in cirrhotic patients. Area under the curve was 0.517 with 95% confidence interval and the = 0.77. However, positive correlation was present between the NT-ProBNP value and two echocardiographic parameters of diastolic dysfunction (E/A, E/E').
Increased serum NT-ProBNP levels in cirrhosis of liver have a positive correlation with echocardiographic measures of diastolic dysfunction of the heart but it is not a good tool for screening for cirrhotic cardiomyopathy.
40%-60%的肝硬化患者伴有心脏功能障碍。血清N末端B型利钠肽原（NT-ProBNP）是肝硬化性心肌病的一个潜在附加标志物。
这是一项在印度南部一家三级医疗中心对100例肝硬化患者进行的横断面分析研究。对95例患者通过二尖瓣血流参数以及左心室组织多普勒成像评估舒张功能。在纳入研究时一次性测定血清NT-ProBNP水平。对超声心动图参数异常的患者诊断为肝硬化性心肌病，并分析其与NT-Pro BNP水平的相关性。使用SPSS 22版软件进行数据分析。
40例（42.1%）参与者存在舒张功能障碍。22例（23.2%）为I级舒张功能障碍,16例（16.8%）为II级，2例（2.1%）为III级舒张功能障碍。舒张功能障碍患者的平均NT-Pro-BNP升高（107.38 [±66.76] ng/ml）。与病情较轻的患者相比，Child-Pugh B级和C级疾病患者NT-ProBNP更高。NT-ProBNP并非肝硬化患者心肌病的良好筛查工具曲线下面积为0.517,95%置信区间，P = 0.77。然而,NT-ProBNP值与舒张功能障碍两个超声心动图参数（E/A,E/E'）之间存在正相关关系。
肝硬化患者血清NT-ProBNP水平升高与心脏舒张功能障碍超声心动图测量值呈正相关，但它并非筛查肝硬化性心肌病的良好工具。
