| Short-term effects of transjugular intrahepatic shunt on cardiac function assessed by cardiac MRI: preliminary results. | |
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MedLine Citation:
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PMID: 19730936 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The purpose of this study was to assess shortterm effects of transjugular intrahepatic shunt (TIPS) on cardiac function with cardiac magnetic resonance imaging (MRI) in patients with liver cirrhosis. Eleven patients (six males and five females) with intractable esophageal varices or refractory ascites were imaged with MRI at 1.5 T prior to, within 24 h after, and 4-6 months after TIPS creation (n = 5). Invasive pressures were registered during TIPS creation. MRI consisted of a stack of contiguous slices as well as phase contrast images at all four valve planes and perpendicular to the portal vein. Imaging data were analyzed through time-volume curves and first derivatives. The portoatrial pressure gradient decreased from 19.8 + or = 2.3 to 6.6 + or = 2.3, accompanied by a nearly two fold increase in central pressures and pulmonary capillary wedge pressure immediately after TIPS creation. Left and right end diastolic volumes and stroke volumes increased by 11, 13, and 24%, respectively (p\0.001), but dropped back to baseline at follow-up. End systolic volumes remained unchanged. E/A ratios remained within normal range. During follow-up the left ventricular mass was larger than baseline values in all patients, with an average increase of 7.9 g (p\0.001). In conclusion, the increased volume load shunted to the heart after TIPS creation transiently exceeded the preload reserve of the right and left ventricle, leading to significantly increased pulmonary wedge pressures and persistent enlargement of the left and right atria. Normalization of cardiac dimensions was observed after months together with mild left ventricular hypertrophy. |
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Authors:
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A Kovács; M Schepke; J Heller; H H Schild; S Flacke |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular and interventional radiology Volume: 33 ISSN: 1432-086X ISO Abbreviation: Cardiovasc Intervent Radiol Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-25 Completed Date: 2010-07-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003538 Medline TA: Cardiovasc Intervent Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 290-6 Citation Subset: IM |
Affiliation:
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Department of Radiology, University of Bonn, Sigmund-Freud Str. 25, 53105 Bonn, Germany. Attila.Kovacs@ukb.uni-bonn.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Ascites / complications, diagnosis, surgery Cardiac Output Cardiomyopathies / diagnosis*, etiology, mortality, surgery* Cohort Studies Esophageal and Gastric Varices / complications, diagnosis, surgery Female Follow-Up Studies Heart Function Tests Humans Liver Cirrhosis / complications*, diagnosis, mortality, surgery* Magnetic Resonance Imaging* Male Middle Aged Palliative Care / methods Portasystemic Shunt, Transjugular Intrahepatic / methods* Probability Prospective Studies Pulmonary Wedge Pressure Risk Assessment Severity of Illness Index Statistics, Nonparametric Stroke Volume Survival Rate Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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