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KMID : 0385920090200030310
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Journal of the Korean Society of Emergency Medicine
2009 Volume.20 No. 3 p.310 ~ p.315
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Clinical Investigation of pro-BNP in Hepatic Cirrhosis Patients in an Emergency Department
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Lee Seok-Woo
Park Jung-Soo
Kim Hoon
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Abstract
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Purpose: Cardiac dysfunction may be present in patients with hepatic cirrhosis. This study was performed to evaluate the plasma concentration of pro Brain Natriuretic Peptide (pro-BNP), a marker of severity of hepatic cirrhosis and cardiac dysfunction.
Methods: We retrospectively analyzed the medical records of 85 patients who had been diagnosed with hepatic cirrhosis and admitted through the emergency department. Circulating levels of pro-BNP, Child-Pugh class and Sequential Organ Failure Assessment (SOFA) score were determined.
Results: Plasma pro-BNP levels were significantly increased in cirrhotic patients with ascites or heart failure (p=0.000, p=0.000, respectively) but not in patients with encephalopathy or gastrointestinal bleeding (p=0.396, p=0.059, respectively). Circulating pro-BNP levels were closely correlated with SOFA scores (r=0.331, p=0.002) and correlated with Modified Child-Pugh classification scores (r=0.273, p=0.033). The SOFA score is an easily applied tool with good prognostic abilities, but pro-BNP and Child-Pugh class can also be used to enhance clinical judgment of prognosis.
Conclusion: Increased pro-BNP levels are likely related to the severity of disease in hepatic cirrhosis. Advanced cirrhosis is associated with advanced cardiac dysfunction and pro-BNP has prognostic value for cirrhosis.
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KEYWORD
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Liver cirrhosis, Pro-brain natriuretic peptide
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