Cardiac dysfunction in cirrhosis: a 2-year longitudinal follow-up study using advanced cardiac imaging

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Cardiac dysfunction in cirrhosis : a 2-year longitudinal follow-up study using advanced cardiac imaging. / Wiese, Signe; Hove, Jens D.; Mo, Silje; Mygind, Naja D.; Tønnesen, Jacob; Petersen, Claus L.; Clemmesen, Jens Otto; Goetze, Jens Peter; Bendtsen, Flemming; Møller, Søren.

I: American Journal of Physiology: Gastrointestinal and Liver Physiology, Bind 317, 2019, s. G253–G263.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Wiese, S, Hove, JD, Mo, S, Mygind, ND, Tønnesen, J, Petersen, CL, Clemmesen, JO, Goetze, JP, Bendtsen, F & Møller, S 2019, 'Cardiac dysfunction in cirrhosis: a 2-year longitudinal follow-up study using advanced cardiac imaging', American Journal of Physiology: Gastrointestinal and Liver Physiology, bind 317, s. G253–G263. https://doi.org/10.1152/ajpgi.00402.2018

APA

Wiese, S., Hove, J. D., Mo, S., Mygind, N. D., Tønnesen, J., Petersen, C. L., Clemmesen, J. O., Goetze, J. P., Bendtsen, F., & Møller, S. (2019). Cardiac dysfunction in cirrhosis: a 2-year longitudinal follow-up study using advanced cardiac imaging. American Journal of Physiology: Gastrointestinal and Liver Physiology, 317, G253–G263. https://doi.org/10.1152/ajpgi.00402.2018

Vancouver

Wiese S, Hove JD, Mo S, Mygind ND, Tønnesen J, Petersen CL o.a. Cardiac dysfunction in cirrhosis: a 2-year longitudinal follow-up study using advanced cardiac imaging. American Journal of Physiology: Gastrointestinal and Liver Physiology. 2019;317:G253–G263. https://doi.org/10.1152/ajpgi.00402.2018

Author

Wiese, Signe ; Hove, Jens D. ; Mo, Silje ; Mygind, Naja D. ; Tønnesen, Jacob ; Petersen, Claus L. ; Clemmesen, Jens Otto ; Goetze, Jens Peter ; Bendtsen, Flemming ; Møller, Søren. / Cardiac dysfunction in cirrhosis : a 2-year longitudinal follow-up study using advanced cardiac imaging. I: American Journal of Physiology: Gastrointestinal and Liver Physiology. 2019 ; Bind 317. s. G253–G263.

Bibtex

@article{e87f442b522543b3a013458bb157f67c,
title = "Cardiac dysfunction in cirrhosis: a 2-year longitudinal follow-up study using advanced cardiac imaging",
abstract = "BACKGROUND AND AIMS: The temporal relationship between cirrhotic cardiomyopathy, progression of liver disease, and survival remains unknown. Our aim was to investigate the development of structural and functional cardiac changes over time with the progression of cirrhosis and outcome.METHODS: Sixty-three cirrhotic outpatients (Child class: A=9, B=46, C=8) and 14 healthy controls were included in this 2-year longitudinal study. Advanced cardiac characteristics such as cardiac MRI with extracellular volume (ECV) quantification, speckle tracking echocardiography, and biomarkers were assessed at 0/6/12/18/24 months. Patients were followed-up for a median of 30 months with registration of acute decompensations (AD), liver transplantation (LT), and death.RESULTS: Patients who progressed, underwent LT, or died had more pronounced cardiac dysfunction with structural myocardial changes, and left atrial enlargement. Conversely, limited cardiac deterioration was seen in patients who remained stable or improved in cirrhosis. During follow-up 25 patients developed AD, 4 underwent LT, and 20 died. Mean arterial pressure was the only cardiovascular parameter associated with death in a univariate analysis (P=0.037), and the main predictors were MELD and age. However, last visit myocardial ECV was independently associated with the combined endpoint of LT/death (P=0.001), and in AD patients a low cardiac index was independently associated with death (P=0.01).CONCLUSIONS: Cardiac function seems to deteriorate with the progression of cirrhosis and affects prognosis, especially in patients with AD. Conversely, patients with stable cirrhosis have limited progression in cardiac dysfunction over a 2-year period with modest impact on survival. The results encourage careful cardiac monitoring in advanced cirrhosis.",
author = "Signe Wiese and Hove, {Jens D.} and Silje Mo and Mygind, {Naja D.} and Jacob T{\o}nnesen and Petersen, {Claus L.} and Clemmesen, {Jens Otto} and Goetze, {Jens Peter} and Flemming Bendtsen and S{\o}ren M{\o}ller",
year = "2019",
doi = "10.1152/ajpgi.00402.2018",
language = "English",
volume = "317",
pages = "G253–G263",
journal = "American Journal of Physiology: Gastrointestinal and Liver Physiology",
issn = "0193-1857",
publisher = "American Physiological Society",

}

RIS

TY - JOUR

T1 - Cardiac dysfunction in cirrhosis

T2 - a 2-year longitudinal follow-up study using advanced cardiac imaging

AU - Wiese, Signe

AU - Hove, Jens D.

AU - Mo, Silje

AU - Mygind, Naja D.

AU - Tønnesen, Jacob

AU - Petersen, Claus L.

AU - Clemmesen, Jens Otto

AU - Goetze, Jens Peter

AU - Bendtsen, Flemming

AU - Møller, Søren

PY - 2019

Y1 - 2019

N2 - BACKGROUND AND AIMS: The temporal relationship between cirrhotic cardiomyopathy, progression of liver disease, and survival remains unknown. Our aim was to investigate the development of structural and functional cardiac changes over time with the progression of cirrhosis and outcome.METHODS: Sixty-three cirrhotic outpatients (Child class: A=9, B=46, C=8) and 14 healthy controls were included in this 2-year longitudinal study. Advanced cardiac characteristics such as cardiac MRI with extracellular volume (ECV) quantification, speckle tracking echocardiography, and biomarkers were assessed at 0/6/12/18/24 months. Patients were followed-up for a median of 30 months with registration of acute decompensations (AD), liver transplantation (LT), and death.RESULTS: Patients who progressed, underwent LT, or died had more pronounced cardiac dysfunction with structural myocardial changes, and left atrial enlargement. Conversely, limited cardiac deterioration was seen in patients who remained stable or improved in cirrhosis. During follow-up 25 patients developed AD, 4 underwent LT, and 20 died. Mean arterial pressure was the only cardiovascular parameter associated with death in a univariate analysis (P=0.037), and the main predictors were MELD and age. However, last visit myocardial ECV was independently associated with the combined endpoint of LT/death (P=0.001), and in AD patients a low cardiac index was independently associated with death (P=0.01).CONCLUSIONS: Cardiac function seems to deteriorate with the progression of cirrhosis and affects prognosis, especially in patients with AD. Conversely, patients with stable cirrhosis have limited progression in cardiac dysfunction over a 2-year period with modest impact on survival. The results encourage careful cardiac monitoring in advanced cirrhosis.

AB - BACKGROUND AND AIMS: The temporal relationship between cirrhotic cardiomyopathy, progression of liver disease, and survival remains unknown. Our aim was to investigate the development of structural and functional cardiac changes over time with the progression of cirrhosis and outcome.METHODS: Sixty-three cirrhotic outpatients (Child class: A=9, B=46, C=8) and 14 healthy controls were included in this 2-year longitudinal study. Advanced cardiac characteristics such as cardiac MRI with extracellular volume (ECV) quantification, speckle tracking echocardiography, and biomarkers were assessed at 0/6/12/18/24 months. Patients were followed-up for a median of 30 months with registration of acute decompensations (AD), liver transplantation (LT), and death.RESULTS: Patients who progressed, underwent LT, or died had more pronounced cardiac dysfunction with structural myocardial changes, and left atrial enlargement. Conversely, limited cardiac deterioration was seen in patients who remained stable or improved in cirrhosis. During follow-up 25 patients developed AD, 4 underwent LT, and 20 died. Mean arterial pressure was the only cardiovascular parameter associated with death in a univariate analysis (P=0.037), and the main predictors were MELD and age. However, last visit myocardial ECV was independently associated with the combined endpoint of LT/death (P=0.001), and in AD patients a low cardiac index was independently associated with death (P=0.01).CONCLUSIONS: Cardiac function seems to deteriorate with the progression of cirrhosis and affects prognosis, especially in patients with AD. Conversely, patients with stable cirrhosis have limited progression in cardiac dysfunction over a 2-year period with modest impact on survival. The results encourage careful cardiac monitoring in advanced cirrhosis.

U2 - 10.1152/ajpgi.00402.2018

DO - 10.1152/ajpgi.00402.2018

M3 - Journal article

C2 - 31216181

VL - 317

SP - G253–G263

JO - American Journal of Physiology: Gastrointestinal and Liver Physiology

JF - American Journal of Physiology: Gastrointestinal and Liver Physiology

SN - 0193-1857

ER -

ID: 224704060