Left atrial volume changes assessed by real time 3-dimensional echocardiography in relation to liver function and progno
- PDF / 639,888 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 18 Downloads / 146 Views
ORIGINAL PAPER
Left atrial volume changes assessed by real time 3‑dimensional echocardiography in relation to liver function and prognosis in patients with cirrhosis Signe Wiese1,2 · Mark Liang3,4 · Silje Mo2 · Flemming Bendtsen2 · Jens D. Hove1,3 · Søren Møller1 Received: 22 January 2020 / Accepted: 13 June 2020 © Springer Nature B.V. 2020
Abstract Left atrial enlargement is a known marker of chronic diastolic dysfunction and was recently shown to be an independent predictor of mortality in cirrhosis. Real time 3-dimensional echocardiography (3DE) is an emerging modality that enables accurate measurements of the left atrial (LA) volume and function. Assessment of LA volumes with 3DE has never been applied in cases of cirrhosis. We therefore aimed to investigate LA volumes using the novel 3DE technique in relation to liver dysfunction and outcome in patients with cirrhosis. A prospective study of 47 cirrhotic patients without cardiovascular disease and ten healthy controls. The patients underwent clinical evaluation, blood sampling, liver vein catheterization, ECG and tissue Doppler echocardiography, including 3DE. Patients were followed up for a median of 25 months with registration of death and liver transplantation (LT). 3DE-derived maximal left atrial volume index ( LAVImax) and minimal left atrial volume index (LAVImin) were higher in patients with a Child Pugh score of 8 or higher than in patients with a score lower than 8 (30.0 vs. 22.3 mL/m2, P=0.008 and 14.6 vs. 9.5 mL/m2, P=0.04, respectively). LA volumes correlated with model for end-stage liver disease (MELD) score (r=0.40, P=0.005), hepatic venous pressure gradient (r=0.34, P=0.04), and biochemical markers of advanced liver disease. Twelve patients experienced the composite end-point of death or LT during follow-up and these patients had increased LA volumes with a higher LAVImax (34.3±14.8 vs. 25.9±7.3 mL/m2, P=0.01) and a higher LAVImin (16.3±7.3 vs. 10.8±5.1 mL/m2, P=0.007). Patients with advanced cirrhosis have increased minimal and maximal left atrial volumes, which correlate with the degree of the liver dysfunction and poor prognosis. Keywords Left atrial volume · 3D echocardiography · Liver cirrhosis · Prognosis
Introduction Søren Møller and Jens D. Hove share senior authorship. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10554-020-01920-7) contains supplementary material, which is available to authorized users. * Jens D. Hove [email protected] 1
Center of Functional Imaging and Research, Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, University of Copenhagen, Kettegaard Alle 30, 2650 Hvidovre, Denmark
2
Gastro Unit, Medical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
3
Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
4
Brown University, Providence, RI, USA
Portal hypertension as a complication of cirrhosis is often followed by a number of circulatory abnor
Data Loading...
