Akash Shukla1, Pratin Bhatt2, Deepak Kumar Gupta2, Tejas Modi2, Jatin Patel2, Milind Phadke3, Krantikumar Rathod4, Megha Meshram2, S J Bhatia2. 1. Department of Gastroenterology, Seth G S Medical College and KEM Hospital, Room 1120, Multistory Building, 11th floor, Parel, Mumbai, 400 012, India. akash@kem.edu. 2. Department of Gastroenterology, Seth G S Medical College and KEM Hospital, Room 1120, Multistory Building, 11th floor, Parel, Mumbai, 400 012, India. 3. Department of Cardiology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, 400 012, India. 4. Department of Interventional Radiology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, 400 012, India.
Abstract
BACKGROUND AND AIM: Cirrhotic cardiomyopathy (CCM) is associated with high mortality after transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation in patients with cirrhosis. There is no data about the prevalence or impact of CCM in Budd-Chiari syndrome (BCS). We assessed the prevalence of CCM in patients with BCS and its impact on outcome after radiological intervention. METHODS: Thirty-three consecutive patients with BCS (15 men) and 33 controls with hepatitis B-related cirrhosis (18 men, matched for Child-Pugh score) were evaluated with baseline electrocardiography (ECG), echocardiography (ECHO) and dobutamine stress ECHO, and ECG (DSE). The two groups were compared for prevalence of CCM. Patients with BCS with and without CCM were assessed for development of heart failure, duration of intensive care unit (ICU) stay, and in-hospital mortality immediately after radiological intervention. RESULTS: Fewer patients with BCS had CCM (7/21 vs. 21/33; p = 0.001, OR-0.16, CI [0.05-0.5]), diastolic dysfunction (DD) (0/33 vs. 6/33; p = 0.01, OR-0.06, CI [0.00-1.1]), and prolonged QTc interval (5/33 vs.17/33; p = 0.001, OR-0.16, CI [0.05-0.5]) despite correction for age. Patients with BCS had lower end-systolic and end-diastolic volumes of left and right ventricles. None of the 19 patients (five with CCM) with BCS undergoing radiological intervention (12 TIPS, 4 inferior vena cava, and 3 hepatic vein stenting) developed heart failure or had prolonged ICU stay. There was no in-hospital mortality. CONCLUSION: Patients with BCS have lower frequency of CCM as compared to patients with cirrhosis. CCM may not adversely affect outcomes after radiological interventions.
BACKGROUND AND AIM: Cirrhotic cardiomyopathy (CCM) is associated with high mortality after transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation in patients with cirrhosis. There is no data about the prevalence or impact of CCM in Budd-Chiari syndrome (BCS). We assessed the prevalence of CCM in patients with BCS and its impact on outcome after radiological intervention. METHODS: Thirty-three consecutive patients with BCS (15 men) and 33 controls with hepatitis B-related cirrhosis (18 men, matched for Child-Pugh score) were evaluated with baseline electrocardiography (ECG), echocardiography (ECHO) and dobutamine stress ECHO, and ECG (DSE). The two groups were compared for prevalence of CCM. Patients with BCS with and without CCM were assessed for development of heart failure, duration of intensive care unit (ICU) stay, and in-hospital mortality immediately after radiological intervention. RESULTS: Fewer patients with BCS had CCM (7/21 vs. 21/33; p = 0.001, OR-0.16, CI [0.05-0.5]), diastolic dysfunction (DD) (0/33 vs. 6/33; p = 0.01, OR-0.06, CI [0.00-1.1]), and prolonged QTc interval (5/33 vs.17/33; p = 0.001, OR-0.16, CI [0.05-0.5]) despite correction for age. Patients with BCS had lower end-systolic and end-diastolic volumes of left and right ventricles. None of the 19 patients (five with CCM) with BCS undergoing radiological intervention (12 TIPS, 4 inferior vena cava, and 3 hepatic vein stenting) developed heart failure or had prolonged ICU stay. There was no in-hospital mortality. CONCLUSION:Patients with BCS have lower frequency of CCM as compared to patients with cirrhosis. CCM may not adversely affect outcomes after radiological interventions.
Authors: Manuel Hernández-Guerra; Eric López; Pablo Bellot; Carlos Piera; Juan Turnes; Juan G Abraldes; Jaime Bosch; Juan C García-Pagán Journal: Hepatology Date: 2006-01 Impact factor: 17.425
Authors: Sherif F Nagueh; Christopher P Appleton; Thierry C Gillebert; Paolo N Marino; Jae K Oh; Otto A Smiseth; Alan D Waggoner; Frank A Flachskampf; Patricia A Pellikka; Arturo Evangelista Journal: J Am Soc Echocardiogr Date: 2009-02 Impact factor: 5.251
Authors: Massimo Cazzaniga; Francesco Salerno; Giovanni Pagnozzi; Elena Dionigi; Stefania Visentin; Ilaria Cirello; Daniele Meregaglia; Antonio Nicolini Journal: Gut Date: 2006-11-29 Impact factor: 23.059
Authors: Konstantin Kazankov; Peter Holland-Fischer; Niels H Andersen; Peter Torp; Erik Sloth; Niels K Aagaard; Hendrik Vilstrup Journal: Liver Int Date: 2011-02-15 Impact factor: 5.828