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

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.

MeSH terms

  • Biomarkers / blood
  • Blood Pressure
  • Carcinoma, Hepatocellular / surgery
  • Cardiac Catheterization
  • Cardiac Output
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / epidemiology*
  • Diastole
  • Heart / physiopathology*
  • Heart Diseases / epidemiology
  • Heart Rate
  • Hemodynamics / physiology*
  • Hepatitis B / surgery
  • Hepatitis C / surgery
  • Humans
  • Hypertension / etiology
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / surgery*
  • Liver Cirrhosis, Alcoholic / surgery
  • Liver Neoplasms / surgery
  • Liver Transplantation / physiology*
  • Natriuretic Peptide, Brain / blood*
  • Systole
  • Vascular Resistance

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain