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Study of Serum NT Pro-BNP Levels in Patients with Cirrhosis of Liver
CIRRHOSIS AND COMPLICATIONS
ETIOLOGICAL PROFILE OF CIRRHOSIS IN A HILLY STATE OF NORTH INDIA Brij Sharma, Rishap Marwaha, Sujeet Raina, Neetu Sharma IGMC, Shimla, India
Cirrhosis And Complications
Aim: The etiological profile of cirrhosis is changing across India. Alcohol is now being reported as the most common cause of cirrhosis in India. The other common etiologies include viral (hepatitis b and c), autoimmune, nonalcoholic fatty liver disease (NAFLD) and metabolic causes. There is paucity of data regarding the etiology of cirrhosis from the hilly areas of North India. Materials and Methods: In this prospective observation study, from 1st June 2012 to 31st May 2013, all consecutive patients diagnosed with cirrhosis were included. Cirrhosis was diagnosed on the basis of imaging, Biochemical parameters and presence of varices on endoscopy. A detailed history, clinical examination and etiological evaluation were carried out. Results: A total of 178 patients were evaluated. Among these the most common etiology was alcohol (62.9%) followed by hepatitis B (10.1%), NAFLD (7.9%) and autoimmune (3.9%). Hepatitis C was the etiology in only 2.8% of patients. Wilson disease and cardiac cirrhosis were seen in one patient each respectively. In addition in 9.6% of patients were cryptogenic. Majority of the patients presented in advanced stages. At presentation the Child-Turcotte-Pugh stage A, B and C were seen in 12 (6.7%), 56 (31.4%) and 110 (61.8%) respectively. Ascites was the main complain in 160 pts (89.8) followed by Hepatic Encephalopathy of different Grades in 124 pt (69.7%) GI bleed in 48 pts (27%). Conclusion: Alcohol is the most common cause of cirrhosis in the hilly areas of North India. Most of the patients present with advanced liver disease. Ascites is the most common presentation. Corresponding author: Brij Sharma. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2015.07.239
Background and Aims: B-type natriuretic peptide (BNP) and its prohormone (pro-BNP) are sensitive markers of ventricular dysfunction and presence of myocardial hypertrophy. Although conventional Doppler echocardiography has been used to assess diastolic filling dynamics, this technique is limited in diagnosing left ventricular diastolic dysfunction and there is no single diagnostic test that can identify patients with cirrhotic cardiomyopathy. This study aimed to assess NT pro-BNP levels in patients with cirrhosis of liver. Methods: 80 patients with cirrhosis of liver were included of which 63 were decompensated (Group A) and 17 were compensated (Group B). Diastolic dysfunction was evaluated by echocardiography and serum NT pro-BNP levels were determined. 20 age- and sex matched patients, without evidence of liver or cardiac disease, were taken as controls (Group C). Results: 80 cirrhotic patients (53: M; 27: F; median age, 45 years) were included. Patients with cirrhosis of liver had significantly higher prevalence of diastolic dysfunction (76% vs 24%; P < 0.002) and higher mean NT pro-BNP levels (358.1 260.5 vs. 125.4 35.3 pg/mL; P < 0.001) compared to controls. NT pro-BNP values were significantly higher in patients with decompensated (Group A: n = 63; 463.3 215.5 pg/mL) than in those with compensated cirrhosis (Group B: n = 17; 253.6 80.7 pg/mL; P < 0.001). NT pro-BNP levels significantly increased as Child-Pugh class increased from A to C. Conclusion: NT pro-BNP values were significantly higher in patients with cirrhosis and diastolic dysfunction compared to those without diastolic dysfunction. NT pro-BNP levels increased as the liver disease severity increased which was evident from significantly raised levels in CTP C patients. NT pro-BNP can be a useful non-operator dependent and early marker of cirrhotic cardiomyopathy. http://dx.doi.org/10.1016/j.jceh.2015.07.240
MALNUTRITION IN CIRRHOSIS INCREASES MORBIDITY AND MORTALITY Sudhir Maharshi, Barjesh Chander Sharma, Siddharth Srivastava
STUDY OF SERUM NT PRO-BNP LEVELS IN PATIENTS WITH CIRRHOSIS OF LIVER A. Anand Government Kilpauk Medical College, Chennai, India S46
G B Pant Hospital, New Delhi, India
Background and Aims: Malnutrition is frequently seen in patients with cirrhosis and associated with complications like ascites, hepatic encephalopathy, infections and death. We determined the prevalence © 2015, INASL
ETIOLOGICAL PROFILE OF CIRRHOSIS IN A HILLY STATE OF NORTH INDIA Brij Sharma, Rishap Marwaha, Sujeet Raina, Neetu Sharma IGMC, Shimla, India
Cirrhosis And Complications
Aim: The etiological profile of cirrhosis is changing across India. Alcohol is now being reported as the most common cause of cirrhosis in India. The other common etiologies include viral (hepatitis b and c), autoimmune, nonalcoholic fatty liver disease (NAFLD) and metabolic causes. There is paucity of data regarding the etiology of cirrhosis from the hilly areas of North India. Materials and Methods: In this prospective observation study, from 1st June 2012 to 31st May 2013, all consecutive patients diagnosed with cirrhosis were included. Cirrhosis was diagnosed on the basis of imaging, Biochemical parameters and presence of varices on endoscopy. A detailed history, clinical examination and etiological evaluation were carried out. Results: A total of 178 patients were evaluated. Among these the most common etiology was alcohol (62.9%) followed by hepatitis B (10.1%), NAFLD (7.9%) and autoimmune (3.9%). Hepatitis C was the etiology in only 2.8% of patients. Wilson disease and cardiac cirrhosis were seen in one patient each respectively. In addition in 9.6% of patients were cryptogenic. Majority of the patients presented in advanced stages. At presentation the Child-Turcotte-Pugh stage A, B and C were seen in 12 (6.7%), 56 (31.4%) and 110 (61.8%) respectively. Ascites was the main complain in 160 pts (89.8) followed by Hepatic Encephalopathy of different Grades in 124 pt (69.7%) GI bleed in 48 pts (27%). Conclusion: Alcohol is the most common cause of cirrhosis in the hilly areas of North India. Most of the patients present with advanced liver disease. Ascites is the most common presentation. Corresponding author: Brij Sharma. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2015.07.239
Background and Aims: B-type natriuretic peptide (BNP) and its prohormone (pro-BNP) are sensitive markers of ventricular dysfunction and presence of myocardial hypertrophy. Although conventional Doppler echocardiography has been used to assess diastolic filling dynamics, this technique is limited in diagnosing left ventricular diastolic dysfunction and there is no single diagnostic test that can identify patients with cirrhotic cardiomyopathy. This study aimed to assess NT pro-BNP levels in patients with cirrhosis of liver. Methods: 80 patients with cirrhosis of liver were included of which 63 were decompensated (Group A) and 17 were compensated (Group B). Diastolic dysfunction was evaluated by echocardiography and serum NT pro-BNP levels were determined. 20 age- and sex matched patients, without evidence of liver or cardiac disease, were taken as controls (Group C). Results: 80 cirrhotic patients (53: M; 27: F; median age, 45 years) were included. Patients with cirrhosis of liver had significantly higher prevalence of diastolic dysfunction (76% vs 24%; P < 0.002) and higher mean NT pro-BNP levels (358.1 260.5 vs. 125.4 35.3 pg/mL; P < 0.001) compared to controls. NT pro-BNP values were significantly higher in patients with decompensated (Group A: n = 63; 463.3 215.5 pg/mL) than in those with compensated cirrhosis (Group B: n = 17; 253.6 80.7 pg/mL; P < 0.001). NT pro-BNP levels significantly increased as Child-Pugh class increased from A to C. Conclusion: NT pro-BNP values were significantly higher in patients with cirrhosis and diastolic dysfunction compared to those without diastolic dysfunction. NT pro-BNP levels increased as the liver disease severity increased which was evident from significantly raised levels in CTP C patients. NT pro-BNP can be a useful non-operator dependent and early marker of cirrhotic cardiomyopathy. http://dx.doi.org/10.1016/j.jceh.2015.07.240
MALNUTRITION IN CIRRHOSIS INCREASES MORBIDITY AND MORTALITY Sudhir Maharshi, Barjesh Chander Sharma, Siddharth Srivastava
STUDY OF SERUM NT PRO-BNP LEVELS IN PATIENTS WITH CIRRHOSIS OF LIVER A. Anand Government Kilpauk Medical College, Chennai, India S46
G B Pant Hospital, New Delhi, India
Background and Aims: Malnutrition is frequently seen in patients with cirrhosis and associated with complications like ascites, hepatic encephalopathy, infections and death. We determined the prevalence © 2015, INASL