title: NT-proBNP Changes in Patients with Ascites during Large Volume Paracentesis.
abstract: Background. N-terminal probrain natriuretic peptide (NT-proBNP) is a hormone involved in the regulation of cardiovascular homeostasis. Changes in serum NT-proBNP during large volume paracentesis (LVP) in patients with ascites have never before been examined. Aims. To determine if significant changes in serum NT-proBNP occur in patients undergoing LVP and the associated clinical correlates in patients with cirrhosis. Method. A total of 45 patients with ascites were prospectively recruited. Serum NT-proBNP, biochemistry, and haemodynamics were determined at baseline and at key time points during and after paracentesis. Results. 34 patients were analysed; 19 had ascites due to cirrhosis and 15 from malignancy. In those with cirrhosis, NT-proBNP decreased by 77.3 pg/mL at 2 L of drainage and 94.3 pg/mL at the end of paracentesis, compared with an increase of 10.5 pg/mL and 77.2 pg/mL in cancer patients at the same time points (P = 0.05 and P = 0.03). Only congestive cardiac failure (CCF) was an independent predictor of significant NT-proBNP changes at the end of drainage in cirrhotic patients (P < 0.01). There were no significant changes in haemodynamics or renal biochemistry for either group. Conclusion. Significant reductions in serum NT-proBNP during LVP occur in patients with cirrhosis but not malignancy, and only comorbid CCF appeared to predict such changes.
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Westmead, Sydney, NSW 2145, Australia.
authors.forename: Vi
authors.identifier: 0000-0002-9752-1798
authors.initials: V
authors.lastname: Nguyen
authors.affiliation: Department of Medical Oncology, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Rob
authors.initials: R
authors.lastname: Zielinski
authors.affiliation: Department of Medical Oncology, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Harnett
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Katherine
authors.identifier: 0000-0001-7824-2761
authors.initials: K
authors.lastname: Miller
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Chan
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Nikitha
authors.initials: N
authors.lastname: Vootakuru
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Priya
authors.identifier: 0000-0002-0756-4437
authors.initials: P
authors.lastname: Acharya
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Montaha
authors.initials: M
authors.lastname: Khan
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Oliver
authors.identifier: 0000-0003-1380-8044
authors.initials: O
authors.lastname: Gibbs
authors.affiliation: Department of Medicine, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Sarika
authors.identifier: 0000-0002-5375-4311
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Gastroenterology & Hepatology, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Anjla
authors.identifier: 0000-0002-8164-1285
authors.initials: A
authors.lastname: Devi
authors.affiliation: Department of Gastroenterology & Hepatology, Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Shani
authors.initials: S
authors.lastname: Phillips
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Westmead, Sydney, NSW 2145, Australia.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Westmead, Sydney, NSW 2145, Australia.
authors.forename: David
authors.initials: D
authors.lastname: van der Poorten