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Endotoxin Activity Assay for the Detection of Whole Blood Endotoxemia in Critically Ill Patients
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Endotoxin Activity Assay for the Detection of Whole Blood Endotoxemia in Critically Ill Patients

Published on: June 24, 2019

Frequency and severity of cirrhotic cardiomyopathy and its possible relationship with bacterial endotoxemia

Dimitrios S Karagiannakis1, Jiannis Vlachogiannakos, Georgios Anastasiadis

  • 1Hepatogastroenterology Unit, 1st Department of Medicine Propaedeutic, Medical School of Athens, Laikon General Hospital, 17 Agiou Thoma Street, 11527, Athens, Greece, d_karagiannakis@hotmail.com.

Digestive Diseases and Sciences
|August 3, 2013
PubMed

Insights

Cirrhotic cardiomyopathy, a cardiac dysfunction in cirrhosis patients, is often linked to bacterial endotoxemia. Higher lipopolysaccharide-binding protein (LBP) levels correlate with diastolic dysfunction severity in these patients.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Internal Medicine

Background:

  • Cirrhotic cardiomyopathy is a known cardiac dysfunction in liver cirrhosis.
  • Its exact pathogenesis remains incompletely understood.
  • Bacterial endotoxemia is a potential contributing factor.

Purpose of the Study:

  • To determine the frequency and characteristics of cirrhotic cardiomyopathy.
  • To investigate the role of bacterial endotoxemia in worsening this condition.

Main Methods:

  • Echocardiography (tissue Doppler imaging) was used to assess cardiac function in 45 cirrhotic patients.
  • Diastolic dysfunction was diagnosed and graded using established guidelines.
  • Serum levels of lipopolysaccharide-binding protein (LBP) and cytokines were measured to estimate endotoxemia.

Main Results:

  • Diastolic dysfunction was present in 37.8% of patients; no systolic dysfunction was observed.
  • Patients with grade II diastolic dysfunction showed significantly higher QTc, left atrium volume, Brain Natriuretic Peptide, and LBP levels.
  • The severity of diastolic dysfunction correlated significantly with LBP levels, which were independently associated with diastolic dysfunction.

Conclusions:

  • Cardiac dysfunction is common in cirrhosis.
  • Elevated LBP levels are associated with severe cirrhotic cardiomyopathy and diastolic dysfunction.
  • Bacterial endotoxemia may play a role in aggravating cardiomyopathy in cirrhotic patients.
Abstract

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