Limits...
Hepatorenal syndrome with cirrhotic cardiomyopathy: case report and literature review.

Mocarzel L, Lanzieri P, Nascimento J, Peixoto C, Ribeiro M, Mesquita E - Case Reports Hepatol (2015)

Bottom Line: An association of HRS and cirrhotic cardiomyopathy has been reported recently, but there are no result studies about the use of positive inotropes as part of the acute phase treatment.The patient showed clinical and laboratory improvement of his renal function after the infusion of dobutamine.Clinical studies are needed on HRS therapeutic approach taking into account the myocardial dysfunction as a major contributing factor to renal dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-900 Niterói, RJ, Brazil.

ABSTRACT
The hepatorenal syndrome (HRS) is defined as a potentially reversible kidney failure in patients with cirrhosis and ascites. An association of HRS and cirrhotic cardiomyopathy has been reported recently, but there are no result studies about the use of positive inotropes as part of the acute phase treatment. We report the case of a patient diagnosed with HRS, with high levels of NT pro-BNP, but with normal ejection fraction of the left ventricle, which showed abnormalities in systolic function through speckle tracking in echocardiography, reversible after the infusion of dobutamine. The patient showed clinical and laboratory improvement of his renal function after the infusion of dobutamine. Clinical studies are needed on HRS therapeutic approach taking into account the myocardial dysfunction as a major contributing factor to renal dysfunction.

No MeSH data available.


Related in: MedlinePlus

Speckle tracking echocardiogram with Doppler. Comparison between images during and after dobutamine infusion ((a) and (b)), showing differences in systolic global strain (29% and 18%, resp.).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4385646&req=5

fig1: Speckle tracking echocardiogram with Doppler. Comparison between images during and after dobutamine infusion ((a) and (b)), showing differences in systolic global strain (29% and 18%, resp.).

Mentions: After 24 hours of dobutamine infusion, an echocardiogram was done and showed an ejection fraction of 62.3% (Simpson's method) and a global longitudinal strain of 29%. Dobutamine was then withheld, and his condition was reevaluated after 30 minutes, with a reduction of the systolic global strain to 18% and the ejection fraction to 51.8%. After dobutamine infusion was restarted, there was a normalization of the parameters, as shown in Figure 1.


Hepatorenal syndrome with cirrhotic cardiomyopathy: case report and literature review.

Mocarzel L, Lanzieri P, Nascimento J, Peixoto C, Ribeiro M, Mesquita E - Case Reports Hepatol (2015)

Speckle tracking echocardiogram with Doppler. Comparison between images during and after dobutamine infusion ((a) and (b)), showing differences in systolic global strain (29% and 18%, resp.).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385646&req=5

fig1: Speckle tracking echocardiogram with Doppler. Comparison between images during and after dobutamine infusion ((a) and (b)), showing differences in systolic global strain (29% and 18%, resp.).
Mentions: After 24 hours of dobutamine infusion, an echocardiogram was done and showed an ejection fraction of 62.3% (Simpson's method) and a global longitudinal strain of 29%. Dobutamine was then withheld, and his condition was reevaluated after 30 minutes, with a reduction of the systolic global strain to 18% and the ejection fraction to 51.8%. After dobutamine infusion was restarted, there was a normalization of the parameters, as shown in Figure 1.

Bottom Line: An association of HRS and cirrhotic cardiomyopathy has been reported recently, but there are no result studies about the use of positive inotropes as part of the acute phase treatment.The patient showed clinical and laboratory improvement of his renal function after the infusion of dobutamine.Clinical studies are needed on HRS therapeutic approach taking into account the myocardial dysfunction as a major contributing factor to renal dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hospital Universitário Antônio Pedro (HUAP), Universidade Federal Fluminense (UFF), Rua Marquês de Paraná 303, 7° Andar, Centro, 24033-900 Niterói, RJ, Brazil.

ABSTRACT
The hepatorenal syndrome (HRS) is defined as a potentially reversible kidney failure in patients with cirrhosis and ascites. An association of HRS and cirrhotic cardiomyopathy has been reported recently, but there are no result studies about the use of positive inotropes as part of the acute phase treatment. We report the case of a patient diagnosed with HRS, with high levels of NT pro-BNP, but with normal ejection fraction of the left ventricle, which showed abnormalities in systolic function through speckle tracking in echocardiography, reversible after the infusion of dobutamine. The patient showed clinical and laboratory improvement of his renal function after the infusion of dobutamine. Clinical studies are needed on HRS therapeutic approach taking into account the myocardial dysfunction as a major contributing factor to renal dysfunction.

No MeSH data available.


Related in: MedlinePlus