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

• Verfasst von: Wannhoff, Andreas [VerfasserIn]
• Verfasst von: Wenz, Theresa [VerfasserIn]
• Verfasst von: Weiss, Celine [VerfasserIn]
• Verfasst von: Friedrich, Kilian [VerfasserIn]
• Verfasst von: Rupp, Christian [VerfasserIn]
• Verfasst von: Antoni, Christoph Helmer [VerfasserIn]
• Verfasst von: Stampfl, Ulrike [VerfasserIn]
• Verfasst von: Schemmer, Peter [VerfasserIn]
• Verfasst von: Stremmel, Wolfgang [VerfasserIn]
• Verfasst von: Weiss, Karl Heinz [VerfasserIn]
• Verfasst von: Radeleff, Boris [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Gotthardt, Daniel [VerfasserIn]
• Titel: Cardiac volume overload and pulmonary hypertension in long-term follow-up of patients with a transjugular intrahepatic portosystemic shunt
• Verf.angabe: 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
• E-Jahr: 2016
• Jahr: 26 February 2016
• Umfang: 11 S.
• Fussnoten: Gesehen am 21.05.2019
• Titel Quelle: Enthalten in: Alimentary pharmacology & therapeutics
• Ort Quelle: Oxford : Blackwell Science, 1987
• Jahr Quelle: 2016
• Band/Heft Quelle: 43(2016), 9, Seite 955-965
• ISSN Quelle: 1365-2036
• DOI: doi:10.1111/apt.13569
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1665999667

Abstract

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.