Document Detail


Modifications of cardiac function in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt (TIPS).
MedLine Citation:
PMID:  11808939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The implantation of a transjugular intrahepatic portosystemic shunt (TIPS) has been shown to exacerbate the hyperdynamic circulation and might induce a significant cardiac overload. We investigated cardiac function before and 1, 3, 6, and 12 months after the TIPS procedure in cirrhotic patients. METHODS: Eleven patients with nonalcoholic cirrhosis were evaluated. Cardiovascular parameters were assessed by two-dimensional Doppler echocardiography. RESULTS: After TIPS, the left ventricular diastolic diameter increased from 26.5 +/- 1.8 mm (basal) to 30.0 +/- 2.8 mm (6 months) (p < 0.05), whereas the ejection fraction showed a slight increase (basal, 64.5 +/- 3.3; 6 months, 68.1 +/- 3.2). The left ventricular pre-ejection period and the isovolumetric relaxation time decreased transiently at 1 month (p < 0.05). An increased velocity in all of the components of pulmonary venous flow (systolic, diastolic, and atrial) documented the accelerated fluxes induced by the procedure. The estimated pulmonary systolic arterial pressure also increased at 1 month (29.5 +/- 1.4 vs 44.1 +/- 1.4 mm Hg, p < 0.05). All of these modifications reverted after 6 months. CONCLUSIONS: Our study demonstrates that nonalcoholic cirrhotic patients, without cardiovascular pathologies, show transient modifications in cardiac dimension and function for 3-6 months after TIPS caused by the increased volume load shunted to the heart.
Authors:
Manuela Merli; Valentina Valeriano; Stefania Funaro; Adolfo Francesco Attili; Andrea Masini; Cesare Efrati; Castro Stefano De; Oliviero Riggio
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  97     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-25     Completed Date:  2002-02-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  142-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Medicine, University of Rome La Sapienza, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiovascular Diseases / complications,  ultrasonography*
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Function Tests
Hemodynamics / physiology
Humans
Liver Cirrhosis / complications,  diagnosis,  surgery*
Male
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / methods*
Postoperative Period
Preoperative Care
Probability
Prospective Studies
Sensitivity and Specificity
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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