title: Cardiac function and aminoterminal pro-brain natriuretic peptide levels in liver-transplanted cirrhotic patients.
abstract: BACKGROUND
  Cirrhosis is associated with structural and functional abnormalities of the heart. We examined the evolution of these abnormalities after liver transplantation (LT).
  
  
  METHODS
  Sixty cirrhotic patients, without cardiovascular disease, were included. Clinical data, echocardiography, and aminoterminal pro-brain natriuretic peptide (NT-proBNP) levels were analyzed before and after transplantation. Healthy controls (n = 25) were included for reference.
  
  
  RESULTS
  Before transplantation, cirrhotic patients had higher left atrium diameter, left ventricular (LV) mass index, and ejection fraction than controls. After transplantation, LV mass index increased (105 ± 31 vs. 119 ± 35 g/m(2) ; p < 0.05), diastolic cardiac function deteriorated, expressed as a reduction in E/A wave ratio (1.105 ± 0.295 vs. 0.798 ± 0.248; p < 0.001), and NT-proBNP levels decreased significantly in patients compared to pre-transplantation values (1759 ± 1154 vs. 1117 ± 600 pg/mL; p < 0.001), although they were still above levels found in controls (1117 ± 600 vs. 856 ± 123 pg/mL; p < 0.05). NT-proBNP levels above 2000 pg/mL before transplantation were significantly associated with risk for cardiovascular events after procedure (37% vs. 9%, p = 0.008).
  
  
  CONCLUSIONS
  In cirrhotic patients, diastolic function and cardiac structure deteriorate after LT. Compared to controls, NT-proBNP levels tend to be higher before and after transplantation. The mechanisms and consequences of these results require further study.
authors: Department of Gastroenterology and Hepatology, University Hospital Lozano Blesa, Zaragoza, Spain. vbernalm@gmail.com
authors: Vanesa
authors: V
authors: Bernal
authors: Isaac
authors: I
authors: Pascual
authors: Angel
authors: A
authors: Lanas
authors: Paula
authors: P
authors: Esquivias
authors: Elena
authors: E
authors: Piazuelo
authors: Francisco A
authors: FA
authors: Garcia-Gil
authors: Isaac
authors: I
authors: Lacambra
authors: Miguel A
authors: MA
authors: Simon
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain