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Cambios cardiopulmonares y su asociación con las características clínicas en la hipertensión portal no cirrótica
Harish Gopalakrishna1, My-Le Nguyen2, Maria Mironova3
1Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, United States. hkgp44@gmail.com.
World journal of gastroenterology
|September 4, 2025
Resumen
Los cambios cardiopulmonares como la dilatación vascular intrapulmonar son comunes en la hipertensión portal no cirrótica (HPNC), incluso sin enfermedad hepática avanzada. Estos hallazgos ponen de relieve la importancia de evaluar la función cardíaca y pulmonar en pacientes con NCPH.
Área de la Ciencia:
- Cardiología
- Pulmonología
- Hepatología
Sus antecedentes:
- Las alteraciones cardiopulmonares en la hipertensión portal no cirrótica (NCPH) siguen siendo poco caracterizadas.
- Comprender estos cambios es crucial para el manejo integral del paciente.
Objetivo del estudio:
- Para investigar los cambios cardiopulmonares en la NCPH mediante ecocardiografía transtorácica (ETC).
- Para correlacionar estos hallazgos con las características clínicas en pacientes con NCPH.
Principales métodos:
- Un estudio de cohorte prospectivo en el que participaron 32 sujetos con NCPH y 10 individuos con NCPH preclínicos.
- Se realizó una ecocardiografía transtorácica (ETC) con inyección de solución salina agitada.
- La evaluación clínica incluyó la evaluación de la hipertensión portal, la dilatación vascular intrapulmonar y la cardiomiopatía.
Principales resultados:
- El 40% de los sujetos presentaban VPI y el 9,5% tenían posible hipertensión portopulmonar (SPV > 38 mmHg).
- Las mediciones más altas de AST/ ALT y rigidez hepática (LSM) se asociaron con IPVD.
- La hipertensión portal (PH) se relacionó con un aumento del volumen auricular izquierdo (LAV) y el índice de LAV (LAVI).
Conclusiones:
- Los cambios cardiopulmonares son frecuentes en el NCPH, reflejando los hallazgos en pacientes con cirrosis.
- Estos cambios ocurren a pesar de la preservación de la función sintética del hígado, enfatizando la utilidad del modelo NCPH.
- Se justifica la identificación temprana y el tratamiento de las complicaciones cardiopulmonares en la NCPH.
Palabras clave:
Angiopoietina 2 y sus derivadosÁcidos biliaresCardiomiopatíaLa ecocardiografíaSíndrome hepatopulmonarDilatación vascular intrapulmonarHiperplasia regenerativa de los nódulosEnfermedad vascular porto-sinusoidalHipertensión portopulmonarMolécula de adhesión de las células vasculares 1Más Videos Relacionados
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