Limits...
Predictors of cardiac hepatopathy in patients with right heart failure.

Megalla S, Holtzman D, Aronow WS, Nazari R, Korenfeld S, Schwarcz A, Goldberg Y, Spevack DM - Med. Sci. Monit. (2011)

Bottom Line: On multivariate analysis, higher RV diastolic pressure and etiology for RV dysfunction other than LHF were both associated with CH.Low cardiac output was associated with CH only amongst those without LHF.CH associated with low cardiac output in patients without LHF suggests that low flow may be contributing to the patophysiology in some cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

ABSTRACT

Background: Some patients with right heart failure develop cardiac hepatopathy (CH). The pathophysiology of CH is thought to be secondary to hepatic venous congestion and arterial ischemia. We sought to define the clinical and hemodynamic characteristics associated with CH.

Material/methods: A retrospective cross sectional analysis was performed in which subjects were identified from our institutional cardiology database if echocardiography showed either right ventricular (RV) hypokinesis or dilatation, and was performed within 30 days of right heart catheterization. A chart review was then performed to identify patient clinical characteristics and to determine if the patients had underlying liver disease. Subjects with non-cardiac causes for hepatopathy were excluded.

Results: In 188 included subjects, etiology for right heart dysfunction included left heart failure (LHF), shunt, pulmonary hypertension, mitral- tricuspid- and pulmonic valvular disease. On multivariate analysis, higher RV diastolic pressure and etiology for RV dysfunction other than LHF were both associated with CH. Low cardiac output was associated with CH only amongst those without LHF.

Conclusions: CH is most often seen in subjects with elevated RV diastolic pressure suggesting a congestive cause in most cases. CH associated with low cardiac output in patients without LHF suggests that low flow may be contributing to the patophysiology in some cases.

Show MeSH

Related in: MedlinePlus

Prevalence of cardiac hepatopathy in those with and without left heart failure (LHF) divided amongst different cardiac output (CO) subgroups.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3539469&req=5

f2-medscimonit-17-10-cr537: Prevalence of cardiac hepatopathy in those with and without left heart failure (LHF) divided amongst different cardiac output (CO) subgroups.

Mentions: The relationship of cardiac output and congestive hepatopathy was complex. Overall, the cardiac output was similar in those with CH compared to those without CH, p=0.08, (Table 3). In the whole study sample, cardiac output was not an independent predictor of CH (OR 1.44 [95% CI: 0.73, 2.83], p=0.3). However, within the group of subjects whose RV dysfunction was not caused by left heart failure, low cardiac output was a significant predictor of CH (OR 2.74 [95% CI: 1.08, 6.95]). Accordingly, the prevalence of CH in those with left heart failure was 21%, as compared to 42% in those without left heart failure with preserved cardiac output and 56% in those without left heart failure with reduced cardiac output (Figure 2).


Predictors of cardiac hepatopathy in patients with right heart failure.

Megalla S, Holtzman D, Aronow WS, Nazari R, Korenfeld S, Schwarcz A, Goldberg Y, Spevack DM - Med. Sci. Monit. (2011)

Prevalence of cardiac hepatopathy in those with and without left heart failure (LHF) divided amongst different cardiac output (CO) subgroups.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539469&req=5

f2-medscimonit-17-10-cr537: Prevalence of cardiac hepatopathy in those with and without left heart failure (LHF) divided amongst different cardiac output (CO) subgroups.
Mentions: The relationship of cardiac output and congestive hepatopathy was complex. Overall, the cardiac output was similar in those with CH compared to those without CH, p=0.08, (Table 3). In the whole study sample, cardiac output was not an independent predictor of CH (OR 1.44 [95% CI: 0.73, 2.83], p=0.3). However, within the group of subjects whose RV dysfunction was not caused by left heart failure, low cardiac output was a significant predictor of CH (OR 2.74 [95% CI: 1.08, 6.95]). Accordingly, the prevalence of CH in those with left heart failure was 21%, as compared to 42% in those without left heart failure with preserved cardiac output and 56% in those without left heart failure with reduced cardiac output (Figure 2).

Bottom Line: On multivariate analysis, higher RV diastolic pressure and etiology for RV dysfunction other than LHF were both associated with CH.Low cardiac output was associated with CH only amongst those without LHF.CH associated with low cardiac output in patients without LHF suggests that low flow may be contributing to the patophysiology in some cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Cardiology Division, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

ABSTRACT

Background: Some patients with right heart failure develop cardiac hepatopathy (CH). The pathophysiology of CH is thought to be secondary to hepatic venous congestion and arterial ischemia. We sought to define the clinical and hemodynamic characteristics associated with CH.

Material/methods: A retrospective cross sectional analysis was performed in which subjects were identified from our institutional cardiology database if echocardiography showed either right ventricular (RV) hypokinesis or dilatation, and was performed within 30 days of right heart catheterization. A chart review was then performed to identify patient clinical characteristics and to determine if the patients had underlying liver disease. Subjects with non-cardiac causes for hepatopathy were excluded.

Results: In 188 included subjects, etiology for right heart dysfunction included left heart failure (LHF), shunt, pulmonary hypertension, mitral- tricuspid- and pulmonic valvular disease. On multivariate analysis, higher RV diastolic pressure and etiology for RV dysfunction other than LHF were both associated with CH. Low cardiac output was associated with CH only amongst those without LHF.

Conclusions: CH is most often seen in subjects with elevated RV diastolic pressure suggesting a congestive cause in most cases. CH associated with low cardiac output in patients without LHF suggests that low flow may be contributing to the patophysiology in some cases.

Show MeSH
Related in: MedlinePlus