RELATIONSHIP BETWEEN ETIOLOGY AND DISEASE STAGE WITH DIASTOLIC DYSFUNCTION AND BRAIN NATRIURETIC PEPTIDE IN LIVER CIRRHOSIS

Ayhan Balkan^{1, *}, Melih Bani², Süleyman Sarıgil³, Ertan Vuruşkan³, Abdullah Emre Yıldırım¹, Buğra Tolga Konduk¹, Murat Taner Gülşen¹

¹Gaziantep University, Faculty of Medicine, Department of Gastroenterology, Gaziantep/Turkey - ²Gaziantep University, Faculty of Medicine, Department of İnternal Medicine, Gaziantep/Turkey - ³Gaziantep University, Faculty of Medicine, Department of Cardiology, Gaziantep/Turkey

Introduction: In patients with cirrhosis, left ventricular diastolic dysfunction (LVDD) is an early indicator of cardiac dysfunction. In this study, it was aimed to evaluate the relationship between the etiology and stage of cirrhosis with Tissue Doppler Imaging (TDI) findings and brain natriuretic peptide (BNP).

Materials and methods: Patients with liver cirrhosis (n=100) and healthy controls (n=65) were included in the study. Demographic, etiological, clinical and laboratory findings of the patients were examined. TDI and BNP measurements were made.

Results: LVDD was found in 35% of patients with cirrhosis (n=35) and in 3% of healthy individuals (n=8) (P=0.001). LVDD was detected in 37.2% (n=16) of those with a MELD-Na score of ≤9; 26% (n=13) of those with 10-19; and 85.7% (n=6) of those with 20-29. LVDD was significantly higher in those with a MELD-Na score of 20-29 (P=0.007). BNP was high in 24% (n=24) of cirrhosis patients, while it was normal in all healthy individuals (100%) (n=65). Elevated BNP levels were observed in 34% (n=17) of patients with ascites and 14% (n=7) of those without ascites (P=0.019). BNP level was 59.9±75.6 in Child A patients, 84.0±62.4 in Child B patients, and 103.5±57.1 ng/L in Child C patients (P=0.001). 

Conclusion: In patients with cirrhosis who had a MELD-Na score of ≥20, LVDD was observed at a high rate. BNP increases even more in patients with acid and high Child-Pugh scores. In patients with advanced cirrhosis, TDI and BNP may be important for early diagnosis and treatment of cardiac complications.