Comparison of Doppler Echocardiographic Findings in Patients with Chronic Liver Disease with and without Intrapulmonary Shunt.
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Date
2015
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Abstract
Aims: Doppler echocardiography is the gold standard for the diagnosis of intrapulmonary shunt
(IPS) and screening for portopulmonary hypertension in chronic liver disease (CLD).
Echocardiography has become fundamental to the diagnosis of cirrhotic cardiomyopathy in the last
decade. The purpose of this article was to compare echocardiographic changes in patients with
CLD, with and without IPS. Methodology: A total of 168 patients with CLD and portal hypertension underwent transthoracic
contrast echocardiography and were allocated to two groups: Group 1 – 72 (42.9%) patients with
IPS; and Group 2 – 96 (57.1 %) patients without IPS (control group). Echocardiographic variables
and the presence/absence of IPS were evaluated in bilateral tests, with the level of statistical
significance established at 5% (p < 0.05).
Results: A higher prevalence of moderate diastolic dysfunction was found in patients with IPS (24
vs. 16 patients; p = 0.034). Patients with grade II IPS had a greater frequency of moderate diastolic
dysfunction than those with grade I (16 vs. 8 patients; p = 0.028). No statistically significant
differences between groups were found in left atrial volume (58 vs. 55 ml; p = 0.181) or the
occurrence of pulmonary arterial hypertension (25 vs. 33 patients; p = 0.963).
Conclusion: In the present study, IPS and grade II IPS were associated with moderate diastolic
dysfunction determined by contrast-enhanced transthoracic Doppler echocardiography. Moderate
diastolic dysfunction appeared to be a predictive factor for the onset of intrapulmonary shunt.
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Keywords
Doppler echocardiography, cirrhotic cardiomyopathy, hepatopulmonary syndrome, portal hypertension, schistosomiasis
Citation
Mota Vítor G, Markman-Filho Brivaldo, Macêdo Liana G, Becker Mônica M de C, Lopes Edmundo P de A, Domingues Ana Lúcia C. Comparison of Doppler Echocardiographic Findings in Patients with Chronic Liver Disease with and without Intrapulmonary Shunt. Cardiology and Angiology An International Journal. 2015; 4(3): 127-134.