Document Detail

Reduced prevalence of ischemic events and abnormal supraortic flow patterns in patients with liver cirrhosis.
MedLine Citation:
PMID:  15780058     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A reduced prevalence of cardiovascular diseases has been reported in liver cirrhosis. However, studies focusing on supraortic district of cirrhotic patients are lacking. METHODS: By ultrasound duplex scanning, the presence and severity of atherosclerotic plaques and flow pattern abnormalities were assessed in carotid and vertebral arteries of 118 cirrhotics aged 60.7 +/- 12.8 (1 standard deviation) years, and in 236 controls matched with cirrhotic patients according to age, sex and cigarette smoking. RESULTS: Previous ischemic strokes were significantly less numerous in cirrhotic patients than in controls (0.8% vs. 10.5%; P = 0.0009); also the prevalence of myocardial infarction was significantly reduced (1.7% vs. 6.4%; P = 0.0532). Moreover, cirrhotic patients differed from controls for a lower prevalence of hypertension and hypercholesterolemia, and for a greater proportion of diabetics. Although the presence and severity of atherosclerotic plaques was similar in the two groups, liver cirrhosis was associated with a lower prevalence of abnormal flow patterns (13.6% vs. 29.2%; P = 0.0011). The inverse association of hemodynamic changes with liver cirrhosis persisted after all main risk factors were simultaneously taken into account by multiple logistic regression. However, in the presence of hypertension, hypercholesterolemia and cigarette smoking, the 'protective' effect of cirrhosis on the occurrence of abnormal flow patterns was no longer detectable. CONCLUSIONS: Advanced liver disease is associated with a reduced prevalence of ischemic stroke, which seems to be related to a decreased prevalence of abnormal flow patterns in the supraortic vessels, especially among non-smokers.
Annalisa Berzigotti; Andrea Bonfiglioli; Antonio Muscari; Giampaolo Bianchi; Silvia Libassi; Mauro Bernardi; Marco Zoli
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  25     ISSN:  1478-3223     ISO Abbreviation:  Liver Int.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-22     Completed Date:  2005-07-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Copyright Information:
Copyright Blackwell Munksgaard 2005
Department of Internal Medicine, Cardioangiology, Hepatology, University of Bologna, Bologna 40138, Italy.
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MeSH Terms
Age Distribution
Arteriosclerosis / epidemiology,  ultrasonography
Carotid Stenosis / epidemiology,  ultrasonography*
Case-Control Studies
Hemodynamics / physiology*
Ischemia / epidemiology,  ultrasonography
Liver Cirrhosis / epidemiology,  ultrasonography*
Logistic Models
Middle Aged
Myocardial Ischemia / epidemiology,  ultrasonography*
Reference Values
Regional Blood Flow
Severity of Illness Index
Sex Distribution
Stroke / epidemiology,  ultrasonography*
Ultrasonography, Doppler
Vertebral Artery / pathology,  ultrasonography

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