Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Horvatits, T; Drolz, A; Roedl, K; Herkner, H; Ferlitsch, A; Perkmann, T; Müller, C; Trauner, M; Schenk, P; Fuhrmann, V.
Von Willebrand factor antigen for detection of hepatopulmonary syndrome in patients with cirrhosis.
J Hepatol. 2014; 61(3):544-549
Doi: 10.1016/j.jhep.2014.04.025
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Trauner Michael
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- Abstract:
- Hepatopulmonary syndrome (HPS) occurs in 20-30% of patients with liver cirrhosis and is associated with a >2 fold increased mortality. Endothelial dysfunction seems to play a central role in its pathogenesis. von Willebrand factor antigen (vWF-Ag), an established marker of endothelial dysfunction, is significantly elevated in patients with liver cirrhosis, portal hypertension, and in experimental HPS. Aim of the present study was to evaluate the impact of vWF-Ag as a screening marker for presence of HPS in patients with stable cirrhosis. 145 patients with stable liver cirrhosis were screened for presence of HPS in this prospective cohort type cross sectional diagnostic study. vWF-Ag and SaO2 levels were assessed at time of screening for HPS. Criteria of HPS were fulfilled in 31 (21%) patients. vWF-Ag levels were significantly higher in patients with HPS compared to patients without HPS (p<0.001). Furthermore, vWF-Ag correlated significantly with gas exchange in HPS positive patients (p<0.05). vWF-Ag is an independent predictor of HPS after correction for sex, age, model for endstage-liver disease (MELD), and hepatic venous pressure gradient (HVPG) (OR per 1% increase of vWF-Ag: 1.02, 95% CI: 1.00-1.04, p<0.05). The best cut-off was 328% at a sensitivity of 100% and specificity of 53.5%; positive predictive value: 36.9%; negative predictive value: 100%. HPS is associated with elevated vWF-Ag levels. vWF-Ag may be a useful screening tool for early detection of HPS. Further studies investigating vWF-Ag in HPS will be needed to confirm our findings. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Biomarkers - blood
- Cohort Studies -
- Cross-Sectional Studies -
- Endothelium, Vascular - physiopathology
- Female -
- Hepatopulmonary Syndrome - diagnosis
- Hepatopulmonary Syndrome - epidemiology
- Hepatopulmonary Syndrome - etiology
- Humans -
- Liver Cirrhosis - complications
- Liver Cirrhosis - physiopathology
- Male -
- Mass Screening -
- Middle Aged -
- Predictive Value of Tests -
- Prospective Studies -
- Sensitivity and Specificity -
- von Willebrand Factor - metabolism
- Find related publications in this database (Keywords)
- Hepatopulmonary syndrome
- HPS
- Pulmonary vascular disease
- von Willebrand factor
- vWF-Ag