Role of Quantitation of Saline Bubble Studies in Patients with Liver Cirrhosis.

Autor:	Igata S; Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA. Electronic address: sigata@ucsd.edu., Kono Y; Division of Hepatology, Department of Medicine, University of California, San Diego, CA, USA., Van Houten T; Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA., Hang CT; Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA., Cotter BR; Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA., Strachan MG; Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA., Morikawa N; Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan., DeMaria AN; Division of Cardiology, Department of Medicine, University of California, Sulpizio Cardiovascular Center at UC San Diego Health, San Diego, CA, USA.
Jazyk:	angličtina
Zdroj:	Ultrasound in medicine & biology [Ultrasound Med Biol] 2023 Aug; Vol. 49 (8), pp. 1804-1810. Date of Electronic Publication: 2023 May 16.
DOI:	10.1016/j.ultrasmedbio.2023.04.003
Abstrakt:	Objective: Microbubble contrast echocardiography with a late positive signal enables the detection of intrapulmonary vascular dilation, including hepatopulmonary syndrome, in patients with end-stage liver disease. We assessed the relationship between the severity of bubble study and clinical outcome. Methods: We retrospectively analyzed 163 consecutive patients with liver cirrhosis who underwent an echocardiogram with bubble study from 2018 to 2021. Patients who were diagnosed with a late positive signal were divided into three groups: grade 1 (1-9 bubbles), grade 2 (10-30 bubbles) and grade 3 (>30 bubbles). Results: Fifty-six percent of the patients had a late positive bubble study (grade 1: 31%, grade 2: 23%, grade 3: 46%). Patients with grade 3 had a significantly higher international normalized ratio, model for end-stage liver disease score and Child-Pugh score and a lower peripheral oxygen saturation compared with patients with a negative study. In patients undergoing liver transplant (LT), survival rates were similar among the groups (3-mo: >87%, 1-y: >87%, 2-y: >83%). However, survival rate was lower in grade 3 patients without LT (3-mo: 81%, 1-y: 64%, 2-y: 39%). Conclusion: Patients with grade 3 had much worse mortality without LT compared with other groups. However, after LT, all grades had equal survival. Therefore, patients with grade 3 may be considered as higher priority for LT. Competing Interests: Conflict of interest The authors declare no competing interests. (Copyright © 2023 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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