title: Relationship between NT-proBNP and cardio-renal dysfunction in patients with advanced liver cirrhosis.
abstract: OBJECTIVE
  ProBNP is a sensitive marker of cardiac dysfunction. We assessed the concentration of circulating NT-proBNP in patients with liver cirrhosis in various stages of the disease and its correlation with markers of cardiac and renal dysfunction and with markers of liver disease severity.
  
  
  METHODS
  A number of 88 patients with liver cirrhosis were included in the study, divided into 3 groups: group 1--18 control patients without ascites; group 2--35 non-azotemic patients with ascites; group 3--35 patients with hepatorenal syndrome. The cardiac dysfunction was assessed by measuring the NT-proBNP serum levels and the QTc interval. The markers of renal dysfunction were the estimated glomerular filtration rates--formulas involving creatinine and serum cystatin C. The Child-Pugh score was used to assess the liver disease severity.
  
  
  RESULTS
  The median NT-proBNP serum levels significantly increased in patients with advanced liver cirrhosis (group 3: 960 fmol/ml and group 2: 660 fmol/ml) as compared to group 1 (435 fmol/ml) (p<0.05). A significant direct correlation was found between the NT-proBNP concentration and the QTc interval (r=0.540, p<0.001). The NT-proBNP levels also correlated with the Child-Pugh score (r=0.501, p<0.01), proving the link between the cardiac dysfunction and the liver disease severity. The cardio-renal interrelation is supported by the relationship between the NT-proBNP concentration and the estimated clearances.
  
  
  CONCLUSIONS
  The high NT-proBNP levels in patients with advanced cirrhosis indicate the presence of cardiac dysfunction, which has a role in the pathogenesis of the hepatorenal syndrome.
authors.affiliation: Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor;3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. adriana_cavasi@yahoo.com.
authors.forename: Adriana
authors.initials: A
authors.lastname: Cavasi
authors.affiliation: Integrated Ambulatory of the Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania.
authors.forename: Eduard
authors.initials: E
authors.lastname: Cavasi
authors.affiliation: Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor;3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Mircea
authors.initials: M
authors.lastname: Grigorescu
authors.affiliation: Babes-Bolyai University, Cluj-Napoca, Romania.
authors.forename: Adela
authors.initials: A
authors.lastname: Sitar-Taut
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006530:Hepatorenal Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain