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Cardiac cirrhosis

Patrícia Leitão, André Carvalho, Conceição Guerra, José Gonçalves, Isabel Ramos
Hereditary hemorrhagic telangiectasia or Osler-Weber-Rendu syndrome is a rare autosomal dominant vascular disorder characterized by epistaxis, mucocutaneous telangiectasias, and arteriovenous malformations affecting various organs and systems. The liver is a commonly involved organ (74% of patients with hereditary hemorrhagic telangiectasia), although symptomatic liver disease is quite infrequent. In symptomatic cases, clinical manifestations relate most commonly to the predominant type of vascular shunting present (arteriovenous, arterioportal, or portovenous)...
February 2018: Radiology Case Reports
Nishant Patel, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Jordan C Castle, Narasimham Dasika, Wael E Saad, Ravi N Srinivasa
OBJECTIVE: The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. MATERIALS AND METHODS: Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula...
March 16, 2018: AJR. American Journal of Roentgenology
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
Safi Dokmak, Béatrice Aussilhou, Tiziana Marchese, Nizar Kardoun, François Cauchy, Anne Sophie Schneck, Olivier Soubrane
BACKGROUND: Hepatocellular carcinoma (HCC) can be complicated by major vascular invasion, and resection can be beneficial in some patients.1 Some of these patients are traditionally operated under total vascular exclusion (TVE), refrigeration, extracorporeal circulatory bypass, and cardiac surgery, with high morbidity and mortality.2 However, HCC thrombi are not adherent to the venous wall, and with advances in surgical techniques, resection can be simplified and performed during short-duration TVE alone...
March 13, 2018: Annals of Surgical Oncology
Roxanne Labranche, Guillaume Gilbert, Milena Cerny, Kim-Nhien Vu, Denis Soulières, Damien Olivié, Jean-Sébastien Billiard, Takeshi Yokoo, An Tang
Iron overload is a systemic disorder and is either primary (genetic) or secondary (exogenous iron administration). Primary iron overload is most commonly associated with hereditary hemochromatosis and secondary iron overload with ineffective erythropoiesis (predominantly caused by β-thalassemia major and sickle cell disease) that requires long-term transfusion therapy, leading to transfusional hemosiderosis. Iron overload may lead to liver cirrhosis and hepatocellular carcinoma, in addition to cardiac and endocrine complications...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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
Farid Froghi, Rahul Koti, Kurinchi Gurusamy, Susan Mallett, Douglas Thorburn, Linda Selves, Sarah James, Jeshika Singh, Manuel Pinto, Christine Eastgate, Margaret McNeil, Helder Filipe, Fatima Jichi, Nick Schofield, Daniel Martin, Brian Davidson
BACKGROUND: Patients with liver cirrhosis undergoing liver transplantation have a hyperdynamic circulation which persists into the early postoperative period making accurate assessment of fluid requirements challenging. Goal-directed fluid therapy (GDFT) has been shown to reduce morbidity and mortality in a number of surgery settings. The impact of GDFT in patients undergoing liver transplantation is unknown. A feasibility trial was designed to determine patient and clinician support for recruitment into a randomised controlled trial of GDFT following liver transplantation, adherence to a GDFT protocol, participant withdrawal, and to determine appropriate endpoints for a subsequent larger trial to evaluate the efficacy of GDFT in patients undergoing liver transplantation...
March 7, 2018: Trials
Ajay Reddy Gade, Manisha Patel, Donna R West, Gary A Abrams
OBJECTIVES: Hepatitis C virus (HCV) infection affects >3% of the US population, which over time can lead to cirrhosis and hepatocellular carcinoma. The lack of a reliable screening method for HCV before 1992 resulted in a higher prevalence of the virus in adults with congenital heart disease who underwent corrective surgery that required blood transfusions. Direct-acting antiviral agents such as sofosbuvir/ledipasvir have significantly increased the efficacy of HCV therapy, although use of these medications in adults with congenital heart disease has not been described...
March 2018: Southern Medical Journal
Elias Tsiompanidis, Spyros I Siakavellas, Anastasios Tentolouris, Ioanna Eleftheriadou, Stamatia Chorepsima, Anastasios Manolakis, Konstantinos Oikonomou, Nikolaos Tentolouris
AIM: To examine the impact of liver cirrhosis on QT interval and cardiac autonomic neuropathy (CAN). METHODS: A total of 51 patients with cirrhosis and 51 controls were examined. Standard 12-lead electrocardiogram recordings were obtained and QT as well as corrected QT interval (QTc) and their dispersions (dQT, dQTc) were measured and calculated using a computer-based program. The diagnosis of CAN was based upon the battery of the tests proposed by Ewing and Clarke and the consensus statements of the American Diabetes Association...
February 15, 2018: World Journal of Gastrointestinal Pathophysiology
M J Coenraad, R Porcher, F Bendtsen
In this editorial the roles of systemic inflammation, elevated pressure in portal venous system and heart function and circulation in stable cirrhosis and decompensated cirrhosis with or without organ failures are described.
February 17, 2018: Journal of Hepatology
Andrei Mihai Voiosu, Paul Bălănescu, Ioana Daha, Bianca Smarandache, Aurelia Rădoi, Radu Bogdan Mateescu, Cristian Răsvan Băicuş, Theodor Alexandru Voiosu
BACKGROUND: We aimed to determine the relationship between endocan and cirrhotic cardiomyopathy. MATERIALS AND METHODS: Patients with liver cirrhosis and no heart disease were included in a prospective observational study with liver disease decompensation and death as primary outcomes. RESULTS: 83 cirrhotic patients were included and 32 had cirrhotic cardiomyopathy. Endocan levels were significantly lower in patients with cirrhotic cardiomyopathy (5...
February 16, 2018: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Masanari Kuwabara, Koichiro Niwa, Tomohiko Toyoda, Takeaki Shirai, Shigeru Tateno, Hideo Ohuchi, Yasuhiko Tanaka, Fukiko Ichida, Tomoo Fujisawa, Teiji Akagi, Yoshiki Mori
BACKGROUND: Fontan-associated liver disease (FALD) is an important late complication involving liver dysfunction, such as liver cirrhosis (LC) and hepatocellular carcinoma (HCC), in patients undergoing the Fontan procedure. However, the prevalence, clinical manifestation, and methods of diagnosis of FALD are still not well established.Methods and Results:This study comprised 2 nationwide surveys in Japan. First, the prevalence of LC and/or HCC in patients undergoing the Fontan procedure was determined...
February 14, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Farahnaz Jazaeri, Razieh Afsharmoghaddam, Alireza Abdollahi, Giti Ghamami, Ahmad Reza Dehpour
Cirrhosis is associated with cardiac chronotropic and inotropic dysfunction which is known as cirrhotic cardiomyopathy. Cardiac responsiveness to adrenergic stimulation is impaired in cirrhosis. Moreover, there is vagal nerve dysfunction which is related to neuromodulatory dysfunction of the angiotensin II in the cirrhosis. This study was aimed to explore the hypothesis that administration of Losartan-angiotensin II receptor antagonist increases cardiac chronotropic response to isoproterenol in cirrhotic rats; and if so, whether this is associated with altered cardiac TGF-β receptor expression...
January 2018: Acta Medica Iranica
Georgios N Kalambokis, Ilias Tsiakas, Maria Christaki, Christina Koustousi, Leonidas Christou, Gerasimos Baltayiannis, Dimitrios Christodoulou
BACKGROUND: The aim of this study was to predict the occurrence of hepatorenal syndrome (HRS) and death in patients with advanced cirrhosis and ascites. PATIENTS AND METHODS: We retrospectively evaluated 2-year data of 78 patients with cirrhosis and ascites (Child-Pugh B/C: 45/43). The mean arterial pressure (MAP) and cardiac output (CO) were measured in all patients just before administration of 2 mg of terlipressin and 30 min later. Systemic vascular resistance (SVR) was calculated as MAP/CO...
February 9, 2018: European Journal of Gastroenterology & Hepatology
Anusha Shirwaikar Thomas, Jerry Estep, David W Victor
Transjugular intrahepatic portosystemic shunt (TIPS) is an attractive therapeutic option in cirrhotic patients with recurrent variceal bleeding refractory to medical and endoscopic therapy. There is little known about the use of TIPS in patients with left ventricular assist devices (LVAD). We describe a patient with a durable continuous-flow LVAD and concurrent decompensated cardiac cirrhosis who underwent successful TIPS placement for recurrent variceal bleeding. The patient has had no rebleeding or encephalopathy in >12 months since TIPS placement...
2018: ACG Case Reports Journal
Gonçalo Nunes, Cristina Fonseca, Rita Barosa, Marta Patita, André Gomes, Júlio Botas, Hélder Coelho, Maria José Brito, Jorge Fonseca
The authors describe a 47-year-old man infected with human immunodeficiency virus admitted for ascites and weight loss. Ascitic fluid analysis revealed chylous ascites (triglycerides 444 mg/dl) with negative microbiological tests. Neoplasia, cardiac disease and liver cirrhosis were excluded after an extensive diagnostic workout. Exploratory laparotomy with tissue sampling did not clarify ascites etiology. During hospital admission, patient status gradually deteriorated, severe malnutrition developed and ascites became refractory to diuretics...
February 9, 2018: Clinical Journal of Gastroenterology
Alexander Egbe, Arooj R Khan, William R Miranda, Naser M Ammash, Carole A Warnes, Sameh S Said, Nathaniel W Taggart, Emmanuel Akintoye, Gruschen R Veldtman, Heidi M Connolly
BACKGROUND: The objective was to better understand Doppler hemodynamics and exercise capacity in patients with Fontan palliation by delineating the hemodynamic mechanism for temporal changes in their peak oxygen consumption (V̇o2). METHODS: We performed a retrospective review of adult Fontan patients with systemic left ventricle (LV) who underwent serial transthoracic echocardiograms (TTE) and cardiopulmonary exercise tests (CPET) at Mayo Clinic in 2000-2015. TTE and CPET data were used (1) to determine agreement between V̇o2 and Doppler-derived LV function indices (eg, stroke volume index [SVI] and cardiac index [CI]) and (2) to determine agreement between temporal changes in peak V̇o2 and LV function indices...
February 2018: American Heart Journal
Takashi Onoe, Asuka Tanaka, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
BACKGROUND: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT)...
February 7, 2018: Surgical Case Reports
Sergio A Sánchez-Luna, Kyle E Brown
Hereditary hemochromatosis (HH) can cause cirrhosis and hepatocellular carcinoma (HCC), but the frequency of these complications is controversial. To address this question, we reviewed the experience with HH at an academic medical center that is the sole liver transplantation center in a state with a population that is >90% Caucasian. The records of all subjects with International Classification of Diseases, Ninth Revision, code 275, "disorders of iron metabolism" seen at the University of Iowa Hospitals and Clinics between January 1, 2004 and December 31, 2014 were reviewed, and HFE C282Y homozygotes and C282Y/H63D compound heterozygotes were identified...
July 2017: Hepatology Communications
Paul M Barr, Hongli Li, W Richard Burack, Michael LeBlanc, Sonali M Smith, Ajay K Gopal, Justin D Floyd, Daniel O Persky, Oliver W Press, Richard I Fisher, Jonathan W Friedberg
BACKGROUND: Despite an abundance of therapeutic options, advanced-stage follicular lymphoma remains incurable. Furthermore, the ideal sequence and absolute benefit of post-induction therapy is unclear. We designed SWOG S0801 to assess the efficacy and safety of consolidative radioimmunotherapy and sequential maintenance rituximab following chemoimmunotherapy. METHODS: For this single-arm, phase 2, multicentre study, we enrolled patients aged 18 years and older with a diagnosis of stage III, IV, or bulky stage II follicular lymphoma, grades 1, 2, or 3a, who had not received previous therapy, from from 20 institutions within the United States National Cancer Institute Clinical Trials Network...
March 2018: Lancet Haematology
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