The Study On Cardiac Function And Plasma B-type Natriuretic Peptide Of Patients With Liver Cirrhosis

Objective: To assess the change of cardiac function and plasma b-type natriureticpeptide (B-type natriuretic peptide, BNP) level in patients with liver cirrhosis indifferent Child—Pugh grade，and Analysis the correlation of the ones and abdominaldropsy.Methods: Sixty patients with liver cirrhosis were divided into groups A，B andC(Child A group，Child B group and Child C group)according to the Child—Pughscore,and divided into two groups according to Concurrenting ascites or not. Standardechocardiography assessed the left ventricular ejection fraction(LVEF)，the early(E)andatrial(A)diastolic filling phase(E／A)，and early(E) deceleration time(EDT). Detect theplasma BNP levels by in the60patients. Assess the change of cardiac function andBNP level in patients with liver cirrhosis in different Child—Pugh grade，and Analysisthe cardiac function when the patients with liver cirrhosis were classified according toabdominal dropsy.Results:1. The change of LVEF、EDT and E/A of patients with liver cirrhosis: the LVEF,E/A and EDT in60patients with liver cirrhosis respectively ranged at59.08±1.83%,0.89±0.29and241.53±48.92ms. After Comparison, the LVEF belongedto the normal range,while the E/A were significantly lower than the normal range,andthe EDT were higher than the normal range.2. The relationship between the cardiac function of liver cirrhosis patients andabdominal dropsy：the LVEF, E/A and EDT in ascites group(37cases) respectivelyranged at57.65±1.55%,0.84±0.31and247.89±53.91ms,while in control group(23cases)they respectively ranged at59.78±2.07%,0.98±0.23and231.30±38.53ms. AfterComparison, LVEF in ascites group were significantly higher than those in control group(P<0.05),while there is no obvious correlation between E/A or EDT andabdominal dropsy.3.The relationship between the plasma BNP of liver cirrhosis patients andabdominal dropsy：the plasma BNP levels in ascites group(37cases) ranged at95.81±72.51pg/ml;while in control group(23cases) ranged at57.26±46.24pg/ml. AfterComparison, the plasma BNP levels in ascites group were significantly higher thanthose in control group(P<0.05).4. The relationship between LVEF, E/A,EDT,the plasma BNP levels and Child-Pugh grading: LVEF, E/A,EDT and the plasma BNP levels Respectively ranged at58.69±1.54%，1.05±0.27，238.46±36.52ms and47.29±40.06pg/ml in Child grading A(26cases),and60.23±1.69%，0.89±0.16，236.0±48.60ms,78.49±57.25pg/ml in Childgrading B (22cases),and57.83±1.59，0.55±0.19，258.33±70.04ms，158.80±87.54pg/mlin Child grading C (12cases). The LVEF of Child grading A and B were higher thanChild grading C,and the differences were significant between Child gradingB and C(P<0.05);The E/A were descending with the grade of Child-pugh classification.And theassociations among these three groups were significant (P<0.05,P<0.01).Spearman testshowed that there was obviously negative correlation between E/A and Child-Pughgrading (r=-0.569, P<0.01).The EDT of Child grading C were higher then the othertwo groups,but with no statistical significance. The plasma BNP levels were elevatedwith the grade of Child-pugh classification. And the associations among these threegroups were significant (P<0.05). Spearman test showed that there was obviouslypositive correlation between the plasma BNP level and Child-Pugh grading (r=0.693,P<0.01).Conclusion:1. The cardiac functions of patients with liver cirrhosis is abnormal, especially,thediastolic disfunetions seem more apparen.2. The left ventricular ejection fractio in patients with abdominal dropsy werereduced.3.There is relations between the cardiac function of liver cirrhosis patients and thedegrees of hepatic dysfunction..4. The plasma BNP levels in patients with liver cirrhosis were related to thedamage of liver function and whether be complicated by scites.