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Cirrhosis and diastolic function

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
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...
May 2018: Digestive Diseases and Sciences
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
Maurizio Cesari, Anna Chiara Frigo, Marta Tonon, Paolo Angeli
Cirrhotic cardiomyopathy is associated with poor outcomes in patients with cirrhosis. We investigated if subclinical cardiac morphologic and functional modifications can influence survival in cirrhotic patients during follow-up. A series of cirrhotic patients without cardiovascular or pulmonary disease underwent standard and tissue Doppler echocardiography to assess left ventricular (LV) geometry, systo/diastolic function and the main haemodynamic parameters. After baseline evaluation 115 cirrhotic patients were followed up for at least 6 years...
September 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Raquel Yotti, Cristina Ripoll, Yolanda Benito, Maria Vega Catalina, Jaime Elízaga, Diego Rincón, Francisco Fernández-Avilés, Javier Bermejo, Rafael Bañares
An accurate evaluation of cardiac function in patients with cirrhosis remains a challenge. We used robust echocardiographic indices to characterize left ventricular (LV) systolic function and its relationship to activation of the sympathetic nervous system and inflammation in 59 patients with cirrhosis and 59 age-matched controls. Additionally, in 11 patients we withdrew beta-blockers and diuretics and used phenylephrine and albumin infusion to evaluate the response to acute afterload and preload changes (interventional substudy)...
June 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Bohyun Jang, Ji Won Han, Pil Soo Sung, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Young I Cho, Seung Kew Yoon
Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient's history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35)...
December 2016: Journal of Korean Medical Science
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
M Demir, M Kurt, A B Akçay
BACKGROUND AND AIM: It has been reported that the fragmented QRS (fQRS) is related to left ventricular systolic dysfunction and diastolic dysfunction. The aim of this study was to determine the frequency of fragmented QRS (fQRS) in patients with decompensated cirrhosis and to evaluate the relationship between the presence of fQRS and systolic and diastolic dysfunction. METHOD: PThe study included consecutive 189 patients with decompensated cirrhosis. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings...
April 2016: Acta Gastro-enterologica Belgica
Suthat Liangpunsakul, Rajiv Agarwal
BACKGROUND: Given that alterations in systemic hemodynamics have a profound influence on renal function in patients with cirrhosis, it is surprising that circadian variations in blood pressure (BP) and renal electrolyte excretion have scarcely been studied. Our aims were to define the relationship of 24-h ambulatory BP changes with renal tubular function and to determine the influence of endotoxemia on BP and urinary parameters. METHODS: Forty healthy controls served as a comparator to 20 cirrhotic patients...
February 29, 2016: Nephrology, Dialysis, Transplantation
Luis Ruiz-del-Árbol, Regina Serradilla
During the course of cirrhosis, there is a progressive deterioration of cardiac function manifested by the disappearance of the hyperdynamic circulation due to a failure in heart function with decreased cardiac output. This is due to a deterioration in inotropic and chronotropic function which takes place in parallel with a diastolic dysfunction and cardiac hypertrophy in the absence of other known cardiac disease. Other findings of this specific cardiomyopathy include impaired contractile responsiveness to stress stimuli and electrophysiological abnormalities with prolonged QT interval...
November 7, 2015: World Journal of Gastroenterology: WJG
Roya Sattarzadeh-Badkoubeh, Babak Geraiely, Mohssen Nassiri-Toosi, Ali Jafarian
We assessed different systolic cardiac indices to detect left and right ventricular systolic dysfunction in cirrhotic patients before liver transplantation. Between 2010-2011, 81 consecutive individuals with confirmed hepatic cirrhosis who were a candidate for liver transplantation were enrolled in this study. A total of 32 age and sex matched healthy volunteers were also selected as the control group. A detailed two-dimensional, Color Flow Doppler, and Tissue Doppler echocardiography were performed in all patients and control participants...
August 2015: Acta Medica Iranica
Selcen Yakar Tülüce, Kamil Tülüce, Zafer Çil, Sadık Volkan Emren, Zehra İlke Akyıldız, Oktay Ergene
OBJECTIVE: Cardiac fibrosis is an important contributor to adverse left ventricular (LV) remodeling and arrhythmias in patients with hypertrophic cardiomyopathy (HCM). Galectin-3 (Gal-3) is a novel marker of cardiac fibrosis and inflammation. In this study, we investigated Gal-3 levels in patients with HCM and controls and assessed the relationship between Gal-3 level and echocardiographic indices using strain echocardiography in patients with HCM. METHODS: Forty patients with HCM in sinus rhythm and 35 healthy controls were prospectively enrolled in this case-control study...
May 2016: Anatolian Journal of Cardiology
Khemika Khemakanok, Anant Khositseth, Suporn Treepongkaruna, Sumate Teeraratkul, Wichai Pansrimangkorn, Surasak Leelaudomlipi, Uthen Bunmee, Suthus Sriphojanart
BACKGROUND/AIM: Liver cirrhosis is associated with several cardiac abnormalities. There have been few studies of these abnormalities in cirrhotic children post-liver transplantation (LT). The purpose of this study was to evaluate cardiac abnormalities in cirrhotic children pre- and post-LT. METHODS: All cirrhotic children <15 years of age on a waiting list for LT underwent pre-LT echocardiography to evaluate left ventricular (LV) dimension, mass, and function...
May 2016: Hepatology International
Yan Chen, Albert C Chan, See-Ching Chan, Siu-Ho Chok, William Sharr, James Fung, Ju-Hua Liu, Zhe Zhen, Wai-Ching Sin, Chung-Mau Lo, Hung-Fat Tse, Kai-Hang Yiu
BACKGROUND: Cirrhosis has been shown to be associated with left ventricular (LV) myocardial dysfunction, but studies of right ventricular (RV) function in cirrhotic patients compared with controls are scarce. Limited studies have prospectively evaluated the progression of myocardial function in patients with cirrhosis and assessed changes in cardiac function following liver transplantation (LTx). So the aim of the study was to evaluate biventricular myocardial function in cirrhotic patients and its alteration with or without liver transplantation...
February 2016: Journal of Cardiology
Dimitrios S Karagiannakis, Jiannis Vlachogiannakos, Georgios Anastasiadis, Irini Vafiadis-Zouboulis, Spiros D Ladas
BACKGROUND AND PURPOSE: Left ventricular diastolic dysfunction (LVDD) constitutes the prominent characteristic of cirrhotic cardiomyopathy, but its relevance on the clinical course of cirrhotic patients has not been clearly defined. The aim of the study was to evaluate the relationship of LVDD with the severity and etiology of liver disease and to investigate whether it affects the outcome of cirrhotic patients. METHODS: Cardiac function of 45 cirrhotics was studied by a tissue Doppler imaging echocardiography...
October 2014: Hepatology International
Efstathios D Pagourelias, Panagiota Sotiriou, Christodoulos E Papadopoulos, Evaggelos Cholongitas, Olga Giouleme, Vassilios Vassilikos
Cirrhosis is commonly associated with impaired left ventricular (LV) myocardial contractile reserve to stress and diastolic dysfunction. The aim of this study was to assess LV systolic performance at rest, using both "standard" echocardiographic indices and novel deformation-rotational parameters, in order to elucidate the pathophysiologic basis of cardiac dysfunction in cirrhosis. Seventy-seven men with cirrhosis (mean age 54.4 ± 9.7) of variable Child-Pugh class (A, B, C) and 20 healthy control subjects were prospectively evaluated by standard as well as speckle tracking echocardiography...
February 2016: Echocardiography
Anna Licata, Giuseppina Novo, Daniela Colomba, Antonino Tuttolomondo, Massimo Galia, Calogero Camma'
Cirrhotic heart has been traditionally considered protected from cardiovascular disease, even if a large amount of literature has recently shown that patients affected by chronic liver disease are exposed to cardiovascular events, as well. Since the first recognition of cardiac involvement in cirrhosis, all published studies explain that decompensated cirrhotic patients suffer from haemodynamic changes, currently known as hyperdynamic syndrome, which finally lead to cirrhotic cardiomyopathy. This is defined by the presence of a subclinical systolic dysfunction unmasked under stress conditions, impaired diastolic function and electrophysiological abnormalities, in the absence of any known cardiac disease...
January 2016: Journal of Cardiovascular Medicine
S Marchetta, J Delwaide, R Lancellotti
Even though cardiac disorders were described in alcoholic cirrhosis more than fifty years ago, cirrhotic cardiomyopathy was not defined until the end of the eighties. The term is used to describe all the cardiac structural and functional abnormalities observed in cirrhotic patients without any underlying cardiac disease. This cardiomyopathy is characterized by impaired systolic function, often unmasked during stress, diastolic dysfunction, and electrophysiological abnormalities. It can be detected by the electrocardiogram, transthoracic echocardiography and measurements of cardiac biomarkers (BNP)...
February 2015: Revue Médicale de Liège
David S Goldberg, Michael B Fallon
Patients with chronic liver disease are at risk of extrahepatic complications related to cirrhosis and portal hypertension, as well as organ-specific complications of certain liver diseases. These complications can compromise quality of life, while also increasing morbidity and mortality before and after liver transplantation. Patients with chronic liver disease are at risk for pulmonary complications of hepatopulmonary syndrome and portopulmonary syndrome; the cardiac complication fall under the general concept of cirrhotic cardiomyopathy, which can affect systolic and diastolic function, as well as cardiac conduction...
November 2015: Clinical Gastroenterology and Hepatology
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