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Cardiology and Angiology: An International Journal, ISSN: 2347-520X,Vol.: 4, Issue.: 3


Comparison of Doppler Echocardiographic Findings in Patients with Chronic Liver Disease with and without Intrapulmonary Shunt


Vítor G. Mota1*, Brivaldo Markman-Filho1,2, Liana G. Macêdo3, Mônica M. de C. Becker4, Edmundo P. de A. Lopes1,5 and Ana Lúcia C. Domingues1,5

1Department of Postgraduate, Center for Health Sciences, Federal University of Pernambuco, Recife, PE, Brazil.

2Department of Internal Medicine, Cardiology Division, Federal University of Pernambuco, Recife, PE, Brazil.

3Department of Internal Medicine, Pneumology Division, Otávio de Freitas Hospital, Recife, PE, Brazil.

4Echocardiography Laboratory, Federal University of Pernambuco, Recife, PE, Brazil.

5Department of Internal Medicine, Hepatology Division, Federal University of Pernambuco, Recife, PE, Brazil.

Article Information
(1) Shigenori Ito, Division of Cardiology, Nagoya City East Medical Center Nagoya, Japan.
(1) Jaspinder Kaur, Punjab Institute of Medical Sciences, Punjab, India.
(2) Ernst Glenda, Pulmonary Lab, Perdriel, Argentina.
(3) Li Yao, Zhejiang Chinese Medical University, China.
Complete Peer review History: http://sciencedomain.org/review-history/11505


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.

Keywords :

Doppler echocardiography; cirrhotic cardiomyopathy; hepatopulmonary syndrome; portal hypertension; schistosomiasis.

Full Article - PDF    Page 127-134

DOI : 10.9734/CA/2015/20427

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