Document Detail


Cardiac alterations in cirrhosis: reversibility after liver transplantation.
MedLine Citation:
PMID:  15629509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Liver cirrhosis induces cardiac alterations. We aimed to define these alterations and assess their reversibility after transplantation. METHODS: Cirrhotic patients (n = 40) and controls (n = 15) underwent echocardiography and stress ventriculography. Fifteen cirrhotics were reevaluated 6-12 months after transplantation. RESULTS: Cirrhotics had higher left ventricular wall thickness (9.6+/-1.2 vs. 8.8+/-1.2 mm; P < 0.05) and ejection fraction (73+/-6 vs. 65+/-4%, P < 0.001) than controls. Basal diastolic function was similar. During stress, cirrhotics presented lower increases of heart rate, left ventricular ejection fraction, stroke volume and cardiac index (P < 0.05 for all), and diastolic dysfunction with lower ventricular peak filling rate (P = 0.001). Exercise capacity was reduced (48+/-21 vs. 76+/-24 W; P < 0.001). Ascitic patients exhibited more diastolic dysfunction at rest and during stress compared to non-ascitic patients. Liver transplantation caused regression of ventricular wall thickness (10.2+/-1.3 vs. 9.5+/-1.2 mm; P < 0.05), improvement of diastolic function, and normalization of systolic response and exercise capacity during stress (significant increases in heart rate, ventricular ejection fraction, stroke volume and cardiac index; P < 0.05 for all). CONCLUSIONS: Cardiac alterations in cirrhosis present with mild increases in ventricular wall thickness, diastolic dysfunction that worsens with ascites and physical stress, and abnormal systolic response to stress limiting exercise capacity. Liver transplantation reverses these alterations.
Authors:
Mireia Torregrosa; Santi Aguadé; Laura Dos; Rosa Segura; Antonio Gónzalez; Artur Evangelista; Joan Castell; Carlos Margarit; Rafael Esteban; Jaume Guardia; Joan Genescà
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hepatology     Volume:  42     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-04     Completed Date:  2005-05-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  68-74     Citation Subset:  IM    
Affiliation:
Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Universitat Autónoma de Barcelona, Passeig Vall d'Hebron 119, Barcelona 08035, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Echocardiography
Female
Heart / physiopathology*
Humans
Hypertrophy, Left Ventricular / etiology
Liver Cirrhosis / complications*,  pathology,  physiopathology
Liver Transplantation*
Male
Middle Aged
Myocardium / pathology
Systole
Ventricular Function, Left
Comments/Corrections
Comment In:
J Hepatol. 2005 Jan;42(1):3-4   [PMID:  15629496 ]

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