Søren Møller, Karen V Danielsen, Signe Wiese, Jens D Hove, Flemming Bendtsen
Cirrhosis with portal hypertension and related complications are associated with a high mortality. Excess of circulating vasodilators and cardiodepressive substances lead to a hyperdynamic circulation with changed myocardial structure and function. The entity cirrhotic cardiomyopathy seems to be involved in different aspects of hepatic decompensation, which focuses on new targets of treatment. Areas covered: This review deals with contemporary aspects of cirrhotic cardiomyopathy, and the literature search was undertaken by PubMed with 'cirrhotic' and 'cardiomyopathies' as MeSH Terms...
May 2019: Expert Review of Gastroenterology & Hepatology
Eleni Theocharidou, Olga Giouleme, Sotirios Anastasiadis, Aikaterini Markopoulou, Efstathios Pagourelias, Themistoklis Vassiliadis, Athanasios Fotoglidis, Polyxeni Agorastou, Aristeidis Slavakis, Aikaterini Balaska, Maria G Kouskoura, Thomas D Gossios, Asterios Karagiannis, Christos S Mantzoros
BACKGROUND: The accuracy of diagnosis and clinical implications of the hepatoadrenal syndrome, as currently diagnosed using total cortisol, remain to be validated. AIM: The aim of this study was to assess adrenal function using free cortisol in stable cirrhosis and study the potential implications of any abnormalities for renal and/or cardiac function. METHODS: Sixty-one stable consecutively enrolled patients with cirrhosis underwent assessment of adrenal function using the low-dose short Synacthen test, renal function by 51 Cr-EDTA glomerular filtration rate (GFR), and cardiac function by two-dimensional echocardiography...
June 2019: Digestive Diseases and Sciences
Emily Mae L Yap, Myla Gloria S Supe, Ira I Yu
Background: Cardiac complications among patients with liver cirrhosis have not yet been described among Filipinos. Cirrhotic cardiomyopathy is a rarely described complication that has not been extensively described in literature. This is the first study to describe the electrocardiographic and echocardiographic findings of Filipino patients with liver cirrhosis. Methods: A retrospective analytical study of 148 patients with liver cirrhosis from 2007 to 2016 at the Philippine Heart Center was done...
December 2018: Cardiology Research
Soon Kyu Lee, Myeong Jun Song, Seok Hwan Kim, Hyo Jun Ahn
Background/Aims: Left ventricular diastolic dysfunction (LVDD) is an early manifestation of cardiac dysfunction in patients with liver cirrhosis (LC). However, the effect of LVDD on survival has not been clarified, especially in decompensated LC. Methods: We prospectively enrolled 70 patients with decompensated LC, including ascites or variceal bleeding, at Daejeon St. Mary's Hospital from April 2013 to April 2015. The cardiac function of these patients was evaluated using 2D echocardiography with tissue Doppler imaging...
August 27, 2018: Clinical and Molecular Hepatology
Shreya S Revadi, V Kavitha, A Mooventhan
A 39-year-old, married man was diagnosed with hepatic cirrhosis with portal hypertension and ascites in February 2016. His symptoms as described by him began with generalized body weakness, breathlessness and sudden weight gain of 16 kg within 3 weeks. History of regular intake of alcohol since 7 years and tremendous family stress were present. Patient underwent conventional medication for 6 months and ayurvedic medications for 4 months. In January 2017, he visited our hospital with the same complaints and underwent integrated naturopathy and yoga therapies (INYTs) for 4 weeks along with Ayurveda and conventional medications...
July 19, 2018: Journal of Complementary & Integrative Medicine
Odilson M Silvestre, Alberto Q Farias, Danusa S Ramos, Meive S Furtado, Ana C Rodrigues, Rafael O Ximenes, Daniel F de Campos Mazo, Patricia M Yoshimura Zitelli, Marcio A Diniz, José L Andrade, Celia Strunz, Antônio A Friedmann, Samuel S Lee, Flair J Carrilho, Luiz A C D'Albuquerque, Fernando Bacal
BACKGROUND: Cirrhotic cardiomyopathy is characterized by an attenuated contractile response to stress. Long-term exposure of β-adrenergic receptors to persistently high levels of catecholamines has been implicated in its pathogenesis. We hypothesized that β-blockade with metoprolol could reverse the changes in heart function and morphology in cirrhotic cardiomyopathy. PATIENTS AND METHODS: In this prospective randomized trial, we included 78 patients aged between 18 and 60 years with abnormal cardiac output response under dobutamine stress echocardiography, without primary cardiac disease or a history of alcohol intake...
August 2018: European Journal of Gastroenterology & Hepatology
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 patients with cirrhosis during follow-up. A series of patients with cirrhosis without cardiovascular or pulmonary disease underwent standard and tissue Doppler echocardiography to assess left ventricular geometry, systolic/diastolic function, and the main haemodynamic parameters. After baseline evaluation 115 patients with cirrhosis were followed up for at least 6 years...
July 2018: 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
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