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Ventricular function in cirrhosis and portasystemic shunt: a two-dimensional echocardiographic study
H Keller1, V Bezjak, B Stegaru
1I. Medizinische Klinik, Klinikum Mannheim der Universität Heidelberg, Federal Republic of Germany.
Hepatology (Baltimore, Md.)
|May 1, 1988
Summary
Chronic portasystemic shunts in cirrhosis patients did not significantly strain the heart. Echocardiographic studies show normal systolic function despite hemodynamic changes, unlike acute shunt effects.
Area of Science:
- Cardiology
- Hepatology
- Medical Imaging
Background:
- Advanced liver disease is associated with cardiovascular alterations, termed cirrhotic cardiomyopathy.
- Cirrhosis patients face increased risk of circulatory deterioration under stress.
- Portacaval shunts redirect blood flow, potentially straining the heart.
Purpose of the Study:
- To assess the hemodynamic impact of chronic portasystemic shunts on cardiac function in cirrhosis patients.
- To compare the effects of chronic shunts versus acute shunt opening on the heart.
Main Methods:
- Two-dimensional echocardiography was used.
- Studied 30 patients with cirrhosis and 20 with chronic portasystemic shunts (16-156 months).
Main Results:
- Chronic shunts altered hemodynamics, increasing left ventricular end-diastolic and end-systolic volumes.
- Cardiac output remained high due to increased stroke volume, despite decreased heart rate.
- Systolic ventricular performance parameters were normal; chronic shunts showed no significant cardiac strain.
Conclusions:
- Chronic portasystemic shunts in cirrhosis patients do not impose a clinically significant strain on the heart.
- Hemodynamic changes observed with chronic shunts differ from the acute effects of portacaval shunt opening.