N-terminal brain natriuretic peptide as a diagnostic test in cirrhotic patients with pulmonary arterial hypertension.
BACKGROUND
The aim of this study was to assessed the correlation of N-terminal natriuretic peptide type B (NT-proBNP) with echocardiographic and hemodynamic indexes of right ventricular (RV) function and to evaluate the sensitivity and specificity of Doppler echocardiography in the diagnosis of portopulmonary hypertension.


METHODS
All patients underwent liver transplantation for cirrhosis. We obtained clinical data, NT-proBNP levels, echocardiography, and right heart hemodynamic measurements before transplantation.


RESULTS
Patients with pulmonary hypertension displayed significantly higher levels of NT-proBNP. They also showed higher model for End-stage Liver Disease scores and higher indices of RV overload on cardiac hemodynamics. The negative predictive value of echocardiography to identify pulmonary hypertension was 83%. A correlation was not observed between systolic pulmonary artery pressures measured by the two methods; however, NTproBNP showed a trend toward a significant correlation with mean pulmonary pressure as determined by hemodynamics (r = .3; P < .01).


CONCLUSIONS
We concluded that NT-proBNP values showed significant correlations with pulmonary hypertension that could assist in a noninvasive diagnoseis for this group of patients.
Liver Transplant Unit, University Hospital Lozano Blesa, Zaragoza, Spain. vbernalm@gmail.com
V
V
Bernal
I
I
Pascual
P
P
Esquivias
A
A
García-Gil
J M
JM
Mateo
I
I
Lacambra
M T
MT
Serrano
M A
MA
Simón
D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D006328:Cardiac Catheterization; D002302:Cardiac Output; D004562:Electrocardiography; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications; D016031:Liver Transplantation; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011669:Pulmonary Wedge Pressure; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000503:physiopathology
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain