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diastolic dysfunction in cirrhotics

Karen V Danielsen, Signe Wiese, Jens Hove, Flemming Bendtsen, Søren Møller
BACKGROUND: The relation between excessive alcohol consumption and coronary arteriosclerosis has remained controversial. The etiology of cirrhosis has been considered a substantial risk factor for development of arteriosclerotic lesions. The coronary artery calcium-score derived from coronary CT angiography is a robust marker of coronary arteriosclerosis. AIMS: To study the burden of coronary arteriosclerosis in cirrhotic patients of various etiologies and association to cardiac dysfunction and survival...
March 8, 2018: Digestive Diseases and Sciences
Akash Shukla, Pratin Bhatt, Deepak Kumar Gupta, Tejas Modi, Jatin Patel, Milind Phadke, Krantikumar Rathod, Megha Meshram, S J Bhatia
BACKGROUND AND AIM: Cirrhotic cardiomyopathy (CCM) is associated with high mortality after transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation in patients with cirrhosis. There is no data about the prevalence or impact of CCM in Budd-Chiari syndrome (BCS). We assessed the prevalence of CCM in patients with BCS and its impact on outcome after radiological intervention. METHODS: Thirty-three consecutive patients with BCS (15 men) and 33 controls with hepatitis B-related cirrhosis (18 men, matched for Child-Pugh score) were evaluated with baseline electrocardiography (ECG), echocardiography (ECHO) and dobutamine stress ECHO, and ECG (DSE)...
January 24, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Roxana Cristina Rimbaş, Sorina Mihăilă Baldea, Ruxandra Drăgoi Galrinho Antunes Guerra, Simona Ionela Visoiu, Mihai Rimbaş, Corina Silvia Pop, Dragoş Vinereanu
There are no clear recommendations regarding cirrhotic cardiomyopathy (CC) evaluation in patients with pre-transplant liver cirrhosis. The roles of new methods, tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE) in the diagnosis and prognosis of cirrhotic cardiomyopathy remain controversial. We investigated the utility of TDI/STE parameters in cirrhotic cardiomyopathy diagnosis and also in predicting mortality in patients with liver cirrhosis. Left/right ventricular function was studied using conventional TDI (velocities) and STE (strain/strain rate)...
March 2018: Ultrasound in Medicine & Biology
Andrei M Voiosu, Signe Wiese, Theodor A Voiosu, Jens Hove, Flemming Bendtsen, Søren Møller
BACKGROUND AND AIMS: Bile acids (BAs) are potent signaling molecules involved in the regulation of several metabolic and functional aspects of cardiovascular homeostasis. BA pool alteration in cirrhosis may contribute toward the development of hemodynamic and cardiac disturbances. We aimed to investigate the association between total BA levels and echocardiographic and biochemical markers of cardiac dysfunction in cirrhotic patients. METHODS: Cirrhotic patients were enrolled prospectively in this hypothesis-generating study and evaluated for cardiac and hemodynamic dysfunction through clinical, echocardiographic, and biochemical means...
April 2018: European Journal of Gastroenterology & Hepatology
Yong-Ho Lee, Kwang Joon Kim, Myung Eun Yoo, Gyuri Kim, Hye-Jin Yoon, Kwanhyeong Jo, Jong-Chan Youn, Mijin Yun, Jun Yong Park, Chi Young Shim, Byung-Wan Lee, Seok-Min Kang, Jong-Won Ha, Bong-Soo Cha, Eun Seok Kang
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is associated with increased cardiovascular risk. Among categories of NAFLD, hepatic fibrosis is most likely to affect mortality. Myocardial function and its energy metabolism are tightly linked, which might be altered by an insulin resistant condition such as NAFLD. We investigated whether hepatic steatosis and fibrosis were associated with myocardial dysfunction relative to myocardial glucose uptake. METHODS: A total of 308 patients (190 without NAFLD, 118 with NAFLD) were studied in a tertiary care hospital...
November 24, 2017: Journal of Hepatology
Cecilia Marconi, Mattia Bellan, Paola Giarda, Rosalba Minisini, Serena Favretto, Michela Emma Burlone, Lisa Franzosi, Mario Pirisi
Background: Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension. Methods: Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Christian Jansen, Alexander Cox, Robert Schueler, Matthias Schneider, Jennifer Lehmann, Michael Praktiknjo, Alessandra Pohlmann, Johannes Chang, Steffen Manekeller, Georg Nickenig, Gabriela Berlakovich, Christian P Strassburg, Christoph Hammerstingl, Katharina Staufer, Jonel Trebicka
Late allocation of organs for transplant impairs post-liver transplantation (LT) survival. Cardiac dysfunction, especially diastolic and autonomic dysfunction, is frequent and plays an important role in the prognosis of patients with cirrhosis. However, the role of myocardial contractility is unexplored, and its prognostic value is controversially discussed. This study analyses the role of myocardial contractility assessed by speckle tracking echocardiography in LT allocation. In total, 168 patients with cirrhosis (training cohort, 111; validation cohort [VC], 57) awaiting LT in 2 centers were included in this retrospective study...
January 2018: Liver Transplantation
Hongqun Liu, Saumya Jayakumar, Mouhieddin Traboulsi, Samuel S Lee
The majority of patients on a waiting list for liver transplantation have end-stage liver disease. Because of the marked peripheral vasodilatation of end-stage cirrhosis that masks a latent myocardial dysfunction, cardiac abnormalities in the resting state are usually subclinical and escape the attention of physicians. However, when challenged, the systolic and diastolic contractile responses are attenuated. In addition to these contractile abnormalities, morphological changes, such as enlargement or hypertrophy of cardiac chambers, and electrophysiological repolarization changes, including a prolonged QT interval, can be observed...
June 2017: Liver Transplantation
Rania Hammami, Mouna Boudabbous, Jihen Jdidi, Fatma Trabelsi, Fakher Mroua, Rahma Kallel, Ali Amouri, Dorra Abid, Nabil Tahri, Leila Abid, Samir Kammoun
Cirrhotic cardiomyopathy is associated with poor prognosis and risk of acute heart failure after liver transplantation or interventional procedures. We aimed to assess the relationship between the severity of cardiac impairment and hepatic disease. Eighty patients and eighty controls underwent echocardiography, tissue Doppler imaging and speckle tracking measures. We assess the correlation between echocardiographic parameters and Child and MELD scores. Systolic parameters function (s wave, p < 0.001) and global longitudinal strain (p < 0...
December 2017: Libyan Journal of Medicine
P Rajaram, A Parekh, M Fisher, J Kempker, R Subramanian
BACKGROUND: In potential liver transplant candidates, pulmonary vascular diseases, including portopulmonary hypertension (PoPH) and pulmonary venous hypertension (PVH), can be associated with high morbidity and mortality. Although there are clear guidelines regarding management and transplant listing criteria for patients with PoPH, the listing criteria for PVH are not well defined. OBJECTIVE: The aim of this study was to describe and compare the perioperative and postoperative morbidity and mortality associated with PoPH and PVH in patients undergoing liver transplantation...
March 2017: Transplantation Proceedings
Saggere M Shasthry, Manoj Kumar, Jelen S Khumuckham, Shiv Kumar Sarin
BACKGROUND & AIMS: Patients with cirrhosis are prone to develop volume over load, have increased capillary permeability and latent or overt cardiomyopathy. Whether albumin infusion causes volume overload in cirrhotics has not been adequately studied. METHODS: Ninety nine consecutive cirrhotic patients receiving 1gm per kg albumin infusion were evaluated for development of volume overload. Clinical, echocardiographic and haemodynamic changes were closely monitored during and after albumin infusion...
August 2017: Liver International: Official Journal of the International Association for the Study of the Liver
D-M Jang, I-G Jun, Y-J Moon, W-J Shin, J-G Song, G-S Hwang
BACKGROUND: Although left ventricular diastolic dysfunction (LVDD) is a pronounced feature of adult cirrhotic cardiomyopathy and a major predictor of poor outcomes following liver transplantation (LT), little is known about if pretransplant cardiac dysfunction affects perioperative outcomes in pediatric LT. METHODS: We retrospectively evaluated pretransplant clinical and Doppler echocardiographic data for 45 consecutive pediatric LT recipients who were treated between 2007 and 2013 (median age = 15 months; interquartile range = 9 to 78 months)...
December 2016: Transplantation Proceedings
Julianne Ahdout, Michael Nurok
Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker...
December 2016: Anesthesiology Clinics
Wael A Abbas, Soheir M Kasem Ahmed, Amal M Abdel Aal, Amal A Mahmoud, Mohamed O Abdelmalek, Mohamed A Mekky, Mohamed A A Abozaid, Ahmed K Ibrahim
BACKGROUND/AIMS: Cirrhotic cardiomyopathy (CCM) is defined as an abnormal heart structure and function in cirrhotic patients. CCM includes systolic and diastolic dysfunction, electrophysiological abnormalities, and structural changes, both microscopic and macroscopic. Currently, there is no one diagnostic test that can identify patients with CCM. Evaluation of the validity of galactin-3 and brain natriuretic peptide (BNP) as biomarkers in the early detection of CCM in comparison to conventional echocardiography...
July 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
A S Rodina, M E Shubina, O P Dudanova
UNLABELLED: The aim of the study was to determine the incidence of cirrhotic cardiomyopathy (CCMP), features of its recognition and clinical manifestations. MATERIALS AND METHODS: The study included 102 patients with alcoholic and viral liver cirrhosis (LC) without cardiovascular history, without viremia and signs of acute alcoholic hepatitis. Echocardiography, electrocardiography (ECG) and brain natriuretic hormone (proBNP) level were investigated in all patients...
2015: Experimental & Clinical Gastroenterology
Søren Møller, Signe Wiese, Hanne Halgreen, Jens D Hove
Development of esophageal varices, ascites, and hepatic nephropathy is among the major complications of cirrhosis. The presence of cirrhotic cardiomyopathy, which includes a left ventricular diastolic dysfunction (DD), seems to deteriorate the course of the disease and the prognosis. Increased stiffness of the cirrhotic heart may decrease the compliance and result in DD. The prevalence of DD in cirrhotic patients averages about 50 %. It can be evaluated by transmitral Doppler echocardiography, tissue Doppler echocardiography, and cardiac magnetic resonance imaging...
September 2016: Heart Failure Reviews
Aya M Fattouh, Mortada H El-Shabrawi, Enas H Mahmoud, Wafaa O Ahmed
BACKGROUND: Cirrhotic cardiomyopathy (CCM) is described as the presence of cardiac dysfunction in cirrhotic patients. In children with chronic liver disease, CCM has been very rarely investigated. THE AIM OF THE STUDY: Is to evaluate the cardiac function of cirrhotic children to identify those with CCM. PATIENTS AND METHODS: Fifty-two cirrhotic patients and 53 age and sex matched controls were assessed using serum brain-type natriuretic peptide (BNP), conventional echocardiography, and tissue Doppler imaging...
January 2016: Annals of Pediatric Cardiology
F Carvalheiro, C Rodrigues, T Adrego, J Viana, H Vieira, C Seco, L Pereira, F Pinto, A Eufrásio, C Bento, E Furtado
BACKGROUND: Patients with liver cirrhosis may develop cirrhotic cardiomyopathy (CC), characterized by blunted contractile responsiveness to stress, diastolic dysfunction (DD), and electrophysiological abnormalities. It may adversely affect the long-term prognosis of these patients. METHODS: We conducted a retrospective analysis of patients undergoing liver transplantation (LT) for cirrhosis from January 2012 to June 2015. We analyzed demographic characteristics, the etiology of cirrhosis, Child-Pugh and Model for End-Stage Liver Disease (MELD) scores, the corrected QT (QTc) interval in the preoperative period, diastolic and systolic dysfunction, mortality and survival, and duration of mechanical ventilation and vasopressor support in the post-LT period...
January 2016: Transplantation Proceedings
Sandra Milić, Davorka Lulić, Davor Štimac, Alen Ružić, Luka Zaputović
Alcoholic liver disease is the most prevalent cause of progressive liver disease in Europe. Alcoholic cirrhosis occurs in 8%-20% of cases of alcoholic liver disease. It has significant influence on cardiovascular system and haemodynamics through increased heart rate, cardiac output, decreased systemic vascular resistance, arterial pressure and plasma volume expansion. Cirrhotic cardiomyopathy is characterised by systolic and diastolic dysfunction and electrophysiological abnormalities, if no other underlying cardiac disease is present...
April 2016: Postgraduate Medical Journal
Mara Barbosa, Joana Guardado, Carla Marinho, Bruno Rosa, Isabel Quelhas, António Lourenço, José Cotter
AIM: To describe the proportion of patients with cirrhotic cardiomyopathy (CCM) evaluated by stress echocardiography and investigating its association with the severity of liver disease. METHODS: A cross-sectional study was conducted. Cirrhotic patients without risk factors for cardiovascular disease were included. Data regarding etiology and severity of liver disease (Child-Pugh score and model for end-stage liver disease), presence of ascites and gastroesophageal varices, pro-brain natriuretic peptide (pro-BNP) and corrected QT (QTc) interval were collected...
January 28, 2016: World Journal of Hepatology
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