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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Wannhoff, A; Hippchen, T; Weiss, CS; Friedrich, K; Rupp, C; Neumann-Haefelin, C; Dollinger, M; Antoni, C; Stampfl, U; Schemmer, P; Stremmel, W; Weiss, KH; Radeleff, B; Katus, HA; Gotthardt, DN.
Cardiac volume overload and pulmonary hypertension in long-term follow-up of patients with a transjugular intrahepatic portosystemic shunt.
Aliment Pharmacol Ther. 2016; 43(9):955-965
Doi: 10.1111/apt.13569
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- Co-authors Med Uni Graz
- Schemmer Peter
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- Abstract:
- Transjugular intrahepatic portosystemic shunt (TIPSS) cause haemodynamic changes in patients with cirrhosis, yet little is known about long-term cardiopulmonary outcomes. To evaluate the long-term cardiopulmonary outcome after TIPSS. 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. 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. 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. © 2016 John Wiley & Sons Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Cardiac Volume - physiology
- Endothelin-1 - metabolism
- Female -
- Follow-Up Studies -
- Hemodynamics -
- Humans -
- Hypertension, Pulmonary - physiopathology
- Liver Cirrhosis - therapy
- Male -
- Middle Aged -
- Portasystemic Shunt, Transjugular Intrahepatic - adverse effects
- Portasystemic Shunt, Transjugular Intrahepatic - methods
- Serotonin - metabolism
- Thromboxane B2 - metabolism