Kishore, R (2020) Study on Association of Serum Brain Natriuretic Peptide (BNP) Level as a Marker of Severity and Cardiac Dysfunction in Liver Cirrhosis. Masters thesis, Madurai Medical College, Madurai.
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Abstract
BACKGROUND: Liver cirrhosis affects cardiovascular system which results in systolic and diastolic dysfunction. There is an impaired stress response with structural changes which can be detected by biochemical parameters like serum brain natriuretic peptide level and prolonged QT interval. BNP is a cardiac neurohormone secreted from ventricles in response to end diastolic pressure and volume overload. Thickness of the left ventricular wall, diastolic dysfunction and stress induced systolic dysfunction are indicative of cirrhotic cardiomyopathy. BNP increases in correlation with severity of cardiac dysfunction. AIMS AND OBJECTIVES: 1. To assess whether serum brain natriuretic peptide (BNP) will increase in liver cirrhosis. 2. To study the association of serum BNP levels as a biochemical marker of severity of cirrhosis. 3. To correlate serum BNP levels with QT interval prolongation and left ventricular end diastolic dimension and use serum BNP levels as a screening tool to identify overt cardiac dysfunction in liver cirrhosis MATERIALS AND METHODS: This study was conducted among 100 patients diagnosed with liver cirrhosis who got admitted in general medicine wards and medical gastroenterology ward at Government Rajaji Hospital, Madurai. Institutional ethical committee approval was obtained. Informed and written consent was obtained from each patient before including them in the study. Ultrasound ,ECHO ,liver function tests, coagulation profile and serum BNP levels was done in all patients and they were classified according to child Pugh classification. DISCUSSION: The end point of liver disease ,so called liver cirrhosis affects many organ systems in the body. cardiovascular complications can occur in liver cirrhosis without any underlying cardiac disease which includes blunted ventricular response to stimuli,systolic and diastolic dysfunction and absence of overt heart failure at rest When such patients are put into stress like variceal bleed and its treatments, developing complications of cirrhosis and liver transplant overt heart failure becomes manifested resulting in sudden deterioration of clinical status of the patient. Serum brain natriuretic peptide levels and prolonged QTc interval was found to increase with worsening Child Pugh score. CONCLUSION: The frequency of high serum BNP levels was statistically significant with worsening child Pugh score. It indicates an association between serum BNP levels with severity of cirrhosis. Serum BNP levels was linearly correlating with prolonged QTc interval and left ventricular end diastolic dimension(LVEDD).This indicates a relationship between biochemical and electrophysiological problems in overloaded heart with cirrhotic cardiomyopathy.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 201711110 |
| Uncontrolled Keywords: | Study on Association of Serum Brain Natriuretic Peptide (BNP) Level as a Marker of Severity and Cardiac Dysfunction in Liver Cirrhosis |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Jan 2021 15:09 |
| Last Modified: | 28 Jan 2021 15:09 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13252 |
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