Evaluation of Cirrhotic Cardiomyopathy in Patients with Hepatocellular Carcinoma by Brain Natriuretic Peptide and Echocardiography Before and After Radiofrequency Ablation

Abstract: Radiofrequency ablation (RFA) is a minimally invasive alternative therapeutic technique for hepatocellular carcinoma (HCC). Cirrhotic cardiomyopathy (CCM) is chronic cardiac dysfunction in patients with cirrhosis and one of its markers is brain natriuretic peptide (BNP). The aim of this study was to evaluate cirrhotic cardiomyopathy in hepatocellular carcinoma patients by brain natriuretic peptide and echocardiography before and after radiofrequency ablation. Patients and Methods: This study was conducted on 30 patients who were divided into: Group I which included twenty patients with hepatocellular carcinoma candidate for radiofrequency ablation as patient group. Group II which included ten patients with liver cirrhosis (child A) as control group. Evaluation of presence of cirrhotic cardiomyopathy in patient group was done by measuring serum BNP level by ELIZA and performing echocardiography before and after radiofrequency ablation by one week. Results: There was insignificant statistical difference between BNP and ejection fraction (EF%) in patient group before RFA( P=0.995). And insignificant correlation between BNP and parameters of cardiac dysfunction in echocardiography (E/A ratio, deceleration time) in patient group before RFA (P=0.117) (P=0.466). One week after RFA, there was insignificant correlation between BNP, EF%, E/A ratio and deceleration time before and after RFA (P>0.05). Conclusion: Serum BNP and echocardiography might not be conclusive or diagnostic for unmasking any mild cardiac dysfunction in (child A) cirrhotic patients after RFA

Early hemodynamic and neurohormonal response after transcatheter aortic valve implantation

The conventional surgical aortic bioprostheses used for treatment of aortic stenosis (AS) are inherently stenotic in nature. The more favorable mechanical profile of the Medtronic CoreValve bioprosthesis may translate into a better hemodynamic and neurohormonal response