Effect of ALBI score on NT-proBNP and diastolic dysfunction in Child-Pugh C cirrhosis
Abstract
Background: The Albumin–Bilirubin (ALBI) score and N-Terminal pro b-type natriuretic peptide (NT-proBNP) are important parameters for detecting asymptomatic left ventricular dysfunction and predicting prognosis in heart failure. Hepatic cirrhosis classified as Child-Pugh C indicates severe liver damage with high risk of cardiovascular complications, including diastolic dysfunction.
Objective: To analyze the effect of the ALBI score on NT-proBNP levels and the degree of diastolic dysfunction in patients with Child-Pugh C hepatic cirrhosis.
Methods: This observational analytic study with a cross-sectional approach involved 54 patients with Child-Pugh C hepatic cirrhosis receiving outpatient and inpatient care at Dr. Moewardi General Hospital, Surakarta. Samples were selected using consecutive sampling and divided into control group (ALBI Grades I–II,n=27) and an intervention group (ALBI Grade III, n=27). NT-proBNP levels were measured using the enzyme immunoassay method, while diastolic function was assessed by echocardiography using E/A ratio, E/e′, deceleration time (DT), tricuspid regurgitation (TR) velocity, and left atrial volume index (LAVI).
Results: The mean NT-proBNP level in the intervention group was significantly higher than in the control group (1926 ± 468 pg/mL vs.1184 ± 351 pg/mL; p=0.032). However, no significant difference was found in the degree of diastolic dysfunction between groups (p=0.234). Grade II diastolic dysfunction occurred in 48.1% of patients with ALBI Grade III and 37.0% with ALBI Grades I–II.
Conclusion: The ALBI score significantly affects NT-proBNP levels but not the degree of diastolic dysfunction. Combined assessment of ALBI and NT-proBNP may support early detection of cardiac dysfunction in advanced hepatic cirrhosis.
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