Positive Correlation between Degree of Liver Cirrhosis and N Terminal–Pro Brain Natriuretic Peptide (NT-pro-BNP)

Mario Steffanus, IDN Wibawa, I Ketut Badjra Nadha
2015 The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy  
Liver cirrhosis (LC) is a chronic disease characterized by damage of liver parenchyme with wide fibrosis and nodules formation. One of LC complications is cirrhotic cardiomyopathy (CC). CC is diagnosed when there are more than one of the following signs: diastolic dysfunction (DD), systolic dysfunction (SD), enlargement of the cardiac chamber, electrophysiology dysfunction, and increasing of natriuretic peptide such as N terminal-pro brain natriuretic peptide (NT-proBNP). The aim of this study
more » ... aim of this study was to determine the correlation between degree of liver cirrhosis and increasing of the NT-proBNP. Method: Cross sectional analytic study was performed with 72 LC patients from May 2014 to May 2015 in Sanglah General Hospital, Denpasar. Degree of liver cirrhosis was determined by child turcotte pugh (CTP) criteria and NT-proBNP was examined by electro chemiluminescence immunoassay (ECLIA) method. LC patients with other disorders which can cause the increase of NT-proBNP were excluded. Statistical analysis used was Spearman's correlation test. Results: Of 72 LC patients, 79.2% were male. Patients with CTP A were 9 (12,5%), CTP B 19 (26, 4%) and CTP C 44 (61,19%). Median of NT-proBNP in CTP A was 112 pg/mL, CTP B 130 pg/mL, and CTP C 315 pg/ mL. There was a strong possitive correlation between degree of liver cirrhosis and NT-proBNP (r = 0.686; p = 0.000). In this study, there was also significant comparison between NT-proBNP and CTP A,B, and C (p = 0,000) and there was no significant relation between NT-proBNP and those cofounding variables (p > 0.05). Conclusion: there was a strong possitive correlation between degree of LC and NT-proBNP. Keyword: liver cirrhosis, child turcotte pugh, NT-proBNP ABSTRAK Latar belakang: Sirosis hati (SH) adalah penyakit hati menahun yang ditandai oleh kerusakan parenkim hati dan fibrosis luas disertai pembentukan nodul. Salah satu komplikasi dari SH adalah kardiomiopati sirosis (KS). Kriteria diagnosis KS adalah ditemukan lebih dari satu kelainan berupa disfungsi diastolik atau disfungsi sistolik, perubahan struktur ruang jantung, gangguan elektrofisiologi, dan peningkatan peptida natriuretik seperti N terminal-pro brain natriuretic peptide (NT-proBNP). Penelitian ini bertujuan untuk mengetahui korelasi antara derajat sirosis hati dengan peningkatan NT-proBNP pada pasien sirosis hati. The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy 74 Mario Steffanus, IDN Wibawa, I Ketut Badjra Nadha Metode: Penelitian ini merupakan studi potong lintang analitik terhadap 72 penderita SH dari Mei 2014 hingga Mei 2015 di Rumah Sakit Umum Sanglah, Denpasar. Derajat sirosis hati ditentukan dengan child turcotte pugh (CTP), dan NT-proBNP diperiksa dengan metode electro chemiluminescence immunoassay (ECLIA). Beberapa kondisi yang mempengaruhi peningkatan NT-proBNP dieksklusi. Korelasi derajat SH dan NT-proBNP dianalisis dengan uji Spearman. Hasil: Dari 72 sampel, 79.2% laki-laki. 9 (12,5%) orang dengan CTP A, 19 (26,4%) orang CTP B, dan 44 (61,1%) orang CTP C. Median nilai NT-proBNP pada CTP A adalah 112 pg/mL, CTP B 130 pg/mL, dan pada CTP C 315 pg/mL. Terdapat korelasi positif kuat yang bermakna antara derajat penyakit SH dengan peningkatan 686 dan p = 0,000). Pada studi ini juga didapatkan perbedaan bermakna NT-proBNP antara kelompok CTP A, B, dan C. Pada studi ini, peningkatan NT-proBNP tidak dipengaruhi oleh variabel perancu (p > 0.05). Simpulan: Terdapat korelasi positif kuat yang bermakna antara derajat SH dengan peningkatan NT-proBNP. Kata kunci: sirosis hati, child turcotte pugh , NT-proBNP
doi:10.24871/162201573-77 fatcat:rvtaentmbje4xjjtsdmzbdpfgi