Cover Image

Cardiac volume overload and pulmonary hypertension in long-term follow-up of patients with a transjugular intrahepatic portosystemic shunt

Background Transjugular intrahepatic portosystemic shunt (TIPSS) cause haemodynamic changes in patients with cirrhosis, yet little is known about long-term cardiopulmonary outcomes. Aim To evaluate the long-term cardiopulmonary outcome after TIPSS. Methods We evaluated cardiopulmonary parameters inc...

Full description

Saved in:
Bibliographic Details
Main Authors: Wannhoff, Andreas (Author) , Wenz, Theresa (Author) , Weiss, Celine (Author) , Friedrich, Kilian (Author) , Rupp, Christian (Author) , Antoni, Christoph Helmer (Author) , Stampfl, Ulrike (Author) , Schemmer, Peter (Author) , Stremmel, Wolfgang (Author) , Weiss, Karl Heinz (Author) , Radeleff, Boris (Author) , Katus, Hugo (Author) , Gotthardt, Daniel (Author)
Format: Article (Journal)
Language:English
Published: 26 February 2016
In: Alimentary pharmacology & therapeutics
Year: 2016, Volume: 43, Issue: 9, Pages: 955-965
ISSN:1365-2036
DOI:10.1111/apt.13569
Online Access:Verlag, Volltext: https://doi.org/10.1111/apt.13569
Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/apt.13569
Get full text
Author Notes:A. Wannhoff, T. Hippchen, C.S. Weiss, K. Friedrich, C. Rupp, C. Neumann‐Haefelin, M. Dollinger, C. Antoni, U. Stampfl, P. Schemmer, W. Stremmel, K.H. Weiss, B. Radeleff, H.A. Katus and D.N. Gotthardt
Description
Summary:Background Transjugular intrahepatic portosystemic shunt (TIPSS) cause haemodynamic changes in patients with cirrhosis, yet little is known about long-term cardiopulmonary outcomes. Aim To evaluate the long-term cardiopulmonary outcome after TIPSS. Methods We evaluated cardiopulmonary parameters including echocardiography during long-term follow-up after TIPSS. Results at 1-5 years after TIPSS were compared to those of cirrhotic controls. Pulmonary hypertension (PH) diagnoses rates were included. Endothelin 1, thromboxane B2 and serotonin were measured. Results We found significant differences 1-5 years after TIPSS compared to pre-implantation values: median left atrial diameter (LAD) increased from 37 mm [interquartile range (IQR): 33-43] to 40 mm (IQR: 37-47, P = 0.001), left ventricular end-diastolic diameter (LV-EDD) increased from 45 mm (range: 41-49) to 48 mm (IQR: 45-52, P < 0.001), pulmonary artery systolic pressure (PASP) increased from 25 mmHg (IQR: 22-33) to 30 mmHg (IQR: 25-36, P = 0.038). Comparing results 1-5 years post-implantation to the comparison cohort revealed significantly higher (P < 0.05) LAD, LV-EDD and PASP values in TIPSS patients. PH prevalence was higher in the shunt group (4.43%) compared to controls (0.91%, P = 0.150). Thromboxane B2 levels correlated with PASP in the TIPSS cohort (P = 0.033). There was no transhepatic gradient observed for the vasoactive substances analysed. Conclusions TIPSS placement is accompanied by long-term cardiovascular changes, including cardiac volume overload, and is associated with an increased rate of pulmonary hypertension. The need for regular cardiac follow-up after TIPSS requires further evaluation.
Item Description:Gesehen am 21.05.2019
Physical Description:Online Resource
ISSN:1365-2036
DOI:10.1111/apt.13569

Similar Items