Limits...
Heart rhythm turbulence and NT-proBNP in decompensated liver cirrhosis--a pilot study.

Poliwczak AR, Białkowska J, Broncel M, Koziróg M, Dworniak K, Kotecka K, Jabłkowski M - Med. Sci. Monit. (2011)

Bottom Line: Significant negative correlation was found between creatinine and TO, and between mean HR and TS, and significant positive correlation was found between LAd and TS.TO values in cirrhotic patients differed significantly from the control group.HRT parameters seem not to be appropriate death predicators.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland. polczak@mp.pl

ABSTRACT

Background: Heart rhythm turbulence (HRT) is a novel tool for evaluation of cardiovascular mortality. Liver cirrhosis is associated with hemodynamic and myocardial disturbances termed cirrhotic cardiomyopathy. In the stable stage of liver cirrhosis, systolic and myocardial dysfunction is correlated with brain natriuretic peptide (BNP). The aim was to evaluate HRT and its correlation with NT-proBNP, echocardiographic and biochemical parameters in patients with decompensation of liver cirrhosis.

Material/methods: The study included 18 patients with decompensated liver cirrhosis and 18 healthy volunteers. Participants underwent echocardiography and 24-hour ECG monitoring. Serum NT-proBNP and other biochemical parameters were measured. Turbulence onset (TO) and turbulence slope (TS) were used to indicate HRT.

Results: Mean HR (87/min vs. 75/min), TO (-0.385% vs. -0.92%), NT-proBNP (304.85 pg/ml vs. 83.2 pg/ml), LAd (42.5 mm vs. 34.5 mm), RVdd (29.5 mm vs. 25 mm), SPAP (36.5 mmHg vs. 22.5 mmHg) were significantly (p<0.05) higher in patients with liver cirrhosis. Patients with normal TO and TS had better stage in Child-Pugh classification (P=0.04) than patients with abnormal values. Significant negative correlation was found between creatinine and TO, and between mean HR and TS, and significant positive correlation was found between LAd and TS. LV diastolic dysfunction was noted in a majority of cirrhotic patients (n=16).

Conclusions: Patients with decompensated cirrhosis had elevated levels of NT-proBNP and LV diastolic dysfunction. TO values in cirrhotic patients differed significantly from the control group. These findings can indicate risk of symptomatic heart failure development and may be a marker of cirrhotic cardiomyopathy. HRT parameters seem not to be appropriate death predicators.

Show MeSH

Related in: MedlinePlus

Scheme of estimation turbulence onset (To) and turbulence slope (Ts).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3539552&req=5

f1-medscimonit-17-6-pr5: Scheme of estimation turbulence onset (To) and turbulence slope (Ts).

Mentions: Heart rhythm turbulence (HRT) is a novel tool for evaluation of cardiovascular mortality. HRT is especially used to evaluate risk of death in a patient with ischemic heart disease and congestive heart failure [1]. HRT describes a short-term heart rhythm (HR) fluctuation in sinus rhythm that follows the ventricular premature beat. Early acceleration followed by late deceleration of sinus rhythm is observed. This phenomenon usually includes 15–20 consecutive beats. It is associated with autonomic nervous system activity and baroreceptor reflex [2]. Two phases of HRT are estimated by the following parameters: turbulence onset (TO) and turbulence slope (TS) (Figure 1).


Heart rhythm turbulence and NT-proBNP in decompensated liver cirrhosis--a pilot study.

Poliwczak AR, Białkowska J, Broncel M, Koziróg M, Dworniak K, Kotecka K, Jabłkowski M - Med. Sci. Monit. (2011)

Scheme of estimation turbulence onset (To) and turbulence slope (Ts).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539552&req=5

f1-medscimonit-17-6-pr5: Scheme of estimation turbulence onset (To) and turbulence slope (Ts).
Mentions: Heart rhythm turbulence (HRT) is a novel tool for evaluation of cardiovascular mortality. HRT is especially used to evaluate risk of death in a patient with ischemic heart disease and congestive heart failure [1]. HRT describes a short-term heart rhythm (HR) fluctuation in sinus rhythm that follows the ventricular premature beat. Early acceleration followed by late deceleration of sinus rhythm is observed. This phenomenon usually includes 15–20 consecutive beats. It is associated with autonomic nervous system activity and baroreceptor reflex [2]. Two phases of HRT are estimated by the following parameters: turbulence onset (TO) and turbulence slope (TS) (Figure 1).

Bottom Line: Significant negative correlation was found between creatinine and TO, and between mean HR and TS, and significant positive correlation was found between LAd and TS.TO values in cirrhotic patients differed significantly from the control group.HRT parameters seem not to be appropriate death predicators.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland. polczak@mp.pl

ABSTRACT

Background: Heart rhythm turbulence (HRT) is a novel tool for evaluation of cardiovascular mortality. Liver cirrhosis is associated with hemodynamic and myocardial disturbances termed cirrhotic cardiomyopathy. In the stable stage of liver cirrhosis, systolic and myocardial dysfunction is correlated with brain natriuretic peptide (BNP). The aim was to evaluate HRT and its correlation with NT-proBNP, echocardiographic and biochemical parameters in patients with decompensation of liver cirrhosis.

Material/methods: The study included 18 patients with decompensated liver cirrhosis and 18 healthy volunteers. Participants underwent echocardiography and 24-hour ECG monitoring. Serum NT-proBNP and other biochemical parameters were measured. Turbulence onset (TO) and turbulence slope (TS) were used to indicate HRT.

Results: Mean HR (87/min vs. 75/min), TO (-0.385% vs. -0.92%), NT-proBNP (304.85 pg/ml vs. 83.2 pg/ml), LAd (42.5 mm vs. 34.5 mm), RVdd (29.5 mm vs. 25 mm), SPAP (36.5 mmHg vs. 22.5 mmHg) were significantly (p<0.05) higher in patients with liver cirrhosis. Patients with normal TO and TS had better stage in Child-Pugh classification (P=0.04) than patients with abnormal values. Significant negative correlation was found between creatinine and TO, and between mean HR and TS, and significant positive correlation was found between LAd and TS. LV diastolic dysfunction was noted in a majority of cirrhotic patients (n=16).

Conclusions: Patients with decompensated cirrhosis had elevated levels of NT-proBNP and LV diastolic dysfunction. TO values in cirrhotic patients differed significantly from the control group. These findings can indicate risk of symptomatic heart failure development and may be a marker of cirrhotic cardiomyopathy. HRT parameters seem not to be appropriate death predicators.

Show MeSH
Related in: MedlinePlus