N-terminal brain natriuretic peptide as a diagnostic test in cirrhotic patients with pulmonary arterial hypertension

Transplant Proc. 2009 Apr;41(3):987-8. doi: 10.1016/j.transproceed.2009.02.025.

Abstract

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).

Conclusion: We concluded that NT-proBNP values showed significant correlations with pulmonary hypertension that could assist in a noninvasive diagnoseis for this group of patients.

MeSH terms

  • Biomarkers / blood
  • Blood Pressure
  • Cardiac Catheterization
  • Cardiac Output
  • Electrocardiography
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / blood*
  • Hypertension, Pulmonary / physiopathology
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / complications
  • Liver Transplantation*
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Pulmonary Wedge Pressure
  • Ventricular Dysfunction, Right / blood
  • Ventricular Dysfunction, Right / physiopathology

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain