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NT-proBNP as a biomarker for hyperdynamic circulation in decompensated cirrhosis

Roman Maslennikov, Anastasia Driga, Konstantine Ivashkin, Vladimir Ivashkin




Aim: To assess NT-proBNP as a biomarker for hyperdynamic circulation in decompensated cirrhosis.
Background: Hyperdynamic circulation is common in decompensated cirrhosis. The previous studies reveal that N-terminal-proBNP
(NT-proBNP) is elevated in cirrhosis.
Methods: A prospective study involved 47 patients with decompensated cirrhosis. All of them underwent echocardiography with
simultaneous measurement of blood pressure and heart rate. Cardiac output and systemic vascular resistance were calculated. The
concentration of NT-proBNP in blood was measured with enzyme-linked immunosorbent assay.
Results: In patients with decompensated cirrhosis, the concentration of NT-proBNP in blood directly correlated with end-diastolic
volume (r=0.482; p<0.001), stroke volume (r= 0.566; p<0.001), cardiac output (r=0.556; p<0.001), volume of the left atrium
(r=0.292; p=0.047), and inversely correlated with systemic vascular resistance (r=-0.538; p<0.001). There was no significant
correlation between NT-proBNP and ejection fraction (p=0.083). Patients with hyperdynamic circulation have higher concentration of
NT-proBNP (152÷476 pg/ml vs. 31÷133 pg/ml, p<0.001) regardless of the presence of diastolic dysfunction (p=0.222). According to
ROC analysis, the best cut-off values for detection of hyperdynamic circulation in decompensated cirrhosis are considered to be 170.0
pg/ml of blood NT-proBNP, showing sensitivity and specificity of 72.0 and 86.4%, respectively. The positive and negative predictive
value are 86.4% and 73.1%, AUC = 0.829 (0.709-0.949).
Conclusion: NT-proBNP may serve as a non-invasive biomarker for hyperdynamic circulation in decompensated cirrhosis.
Keywords: Blood circulation, Liver cirrhosis, Biomarkers, Natriuretic peptide, Brain.
(Please cite as: Maslennikov R, Driga A, Ivashkin K, Ivashkin V. NT-proBNP as a biomarker for hyperdynamic
circulation in decompensated cirrhosis. Gastroenterol Hepatol Bed Bench 2018;11(4):325-332).


Blood Circulation; Liver Cirrhosis; Biomarkers; Natriuretic Peptide, Brain


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DOI: https://doi.org/10.22037/ghfbb.v11i4.1346