Transjugular intrahepatic portosystemic shunt is associated with significant changes in mitral inflow parameters
| Autor: | Tomáš Fejfar, P. Hulek, Rudolf Praus, Radek Pudil, Vaclav Safka, Martina Vasatova, Vaclav Jirkovsky |
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| Předmět: |
Adult
Male medicine.medical_specialty Cardiac output Time Factors Cirrhosis medicine.medical_treatment Diastole Doppler mitral flow Specialties of internal medicine Hemodynamics Kaplan-Meier Estimate Ventricular Function Left Predictive Value of Tests Internal medicine medicine Humans Aged Heart Failure Chi-Square Distribution Hepatology business.industry Stroke Volume General Medicine Stroke volume Middle Aged medicine.disease Echocardiography Doppler Color Surgery RC581-951 Heart failure Liver cirrhosis Hyperdynamic circulation Cardiology Mitral Valve Diastolic dysfunction Female Portasystemic Shunt Transjugular Intrahepatic business Transjugular intrahepatic portosystemic shunt |
| Zdroj: | ResearcherID Scopus-Elsevier Annals of Hepatology, Vol 12, Iss 3, Pp 464-470 (2013) |
| Popis: | Introduction. Liver cirrhosis is associated with hyperdynamic circulation which can result in heart failure. Transjugular intrahepatic portosystemic shunt (TIPS) due to increase of cardiac output is a stressful stimu- lus for cardiovascular system. Therefore, new methods for early detection of heart failure are needed. Transmitral flow is a marker of diastolic dysfunction. Aim. To analyze short- and long-term effect of TIPS procedure on transmitral flow. Material and methods. 55 patients (38 men and 17 women, 55.6 ± 8.9 years) with liver cirrhosis treated with TIPS were enrolled in the study. Echocardiography was performed before, 24 h, 7, 30 and 180 days after the procedure. During 6 month follow up 22 patients died. Results. Left ven- tricle end-diastolic diameter was increasing during the follow-up (baseline: 47 (44.7-51.2) mm, day 7: 50 (46.5-51.3) mm, p < 0.05; day 30: 49.5 (46.7-55.2) mm, p < 0.01; 6 months: 52.5 (48.3-55.2) mm, p < 0.01)). The peak early filling velocity (E) was significantly increasing (before: 75.5 (60.5-87.3) cm/s, 24 h: 88 (74.3-109.7), p < 0.01; day 7: 89 (81.5-105) p < 0.01; 1 month: 94 (82.7-108.5) p < 0.01; 6 month: 91 (80.1-120.2) p < 0.01). Peak late atrial filling velocity (A) significantly increased within 24 h after the procedure: 85.1 (76.2-99.5) vs. 91.2 (81.5-104.5) cm/s, p < 0.05. The E/A ratio was increasing during the follow up (baseline: 0.88, 24 h after: 0.89, 1 week: 1.0, 30 days: 1.13, 6 month: 1.06 p < 0.01). Conclusion. Hemodynamic changes following TIPS procedure can be monitored using echocardiography. Transmitral flow analysis can serve as a useful tool for evaluating of diastolic function in these patients. |
| Databáze: | OpenAIRE |
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