Cirrhotic cardiomyopathy is associated with poor prognosis and risk of acute heart failure after liver transplantation or interventional procedures. We aimed to assess the relationship between the severity of cardiac impairment and hepatic disease. Eighty patients and eighty controls underwent echocardiography, tissue Doppler imaging and speckle tracking measures. We assess the correlation between echocardiographic parameters and Child and MELD scores. Systolic parameters function (s wave, p < 0.001) and global longitudinal strain (p < 0.001) as well as diastolic parameters were significantly more impaired in cirrhotic patients compared to controls. There were no differences among the different groups in ‘Child score’ regarding systolic function as well as diastolic function. Paradoxically, the left atrium size correlated positively to both Child (p = 0.01, r = 0.26) and MELD scores (p = 0.02, r = 0.24). Left ventricular ejection fraction was significantly lower in decompensated patients as compared to compensated patients(p = 0.02).. We did not identify any association between severity of liver disease and cardiac dysfunction. Therefore, a transthoracic echocardiography should be performed in all cirrhotic patients before interventional and surgical procedures regardless of the severity of liver disease.
Background:Rheumatologic manifestations are frequent extraintestinal manifestations (MEI) of chronic inflammatory bowel disease (IBD). Some of these manifestations develop in parallel with the underlying disease, others evolve on their own account. They sometimes lead to reconsider the initial therapy for intestinal purposes.Objectives:The aim of our study is to specify the epidemioclinical characteristics of osteoarticular manifestations of chronic inflammatory bowel disease and their possible impact on intestinal diseaseMethods:This is a retrospective study conducted between January 2000 and December 2015 including patients hospitalized in our department for chronic inflammatory bowel disease (IBD).Results:During the study period, 206 patients with IBD were hospitalized in our department, 78 of whom had rheumatic MEI (frequency equal to 37.8%). These 78 patients were divided into 48 men and 30 women with a sex ratio of 1.6 and an average age of 40.7 ± 13.6 years (18–79). They had Crohn’s disease in 60% of the cases. The average length of service for IBDs was 83 ± 73 months (4–360). Osteoarticular MEIs were peripheral in 56.4% of cases, axial in 29.5% of cases, mixed in 6.41% of cases with the presence of osteopenia in 6.41% of cases and osteoporosis in 1 28%. The activity of IBD associated with these MEI was moderate with an average number of outbreaks / year of 1.6 ± 0.8. These patients were treated with salicylates in 30.7% of the cases using corticosteroid therapy at least once in 23% of the cases. Maintenance treatment based on immunosuppressants was found in 38.46% of cases and anti-TNF alfa in 10.25% of cases. During follow-up, 3 patients died (3.84%). There was no significant difference between patients with IBD with rheumatic MEI and without rheumatic MEI regarding epidemiological data and disease activity.Conclusion:Rheumatic MEIs are found in almost 40% of IBDs. They affect men more frequently than women and Crohn’s disease than UC. They are rather peripheral and do not associate with a more important activity of the disease.References:[1]Journal of the Canadian Association of Gastroenterology, 2019, 2(S1), S73–S80 doi: 10.1093/jcag/gwy053 Supplement ArticleDisclosure of Interests:None declared
Background Bone manifestations are well-known extra hepatic complication of chronic liver disease. The prevalence of osteoporosis among patients with chronic liver diseases ranges from 10% to 60%. Objectives the aim of this study was to assess the prevalence and risk factors of osteoporosis in patients with chronic liver disease. Methods The study was carried out in 60 patients with viral hepatitis B, C and primary biliary cirrhosis (PCB).Bone mineral density (BMD, g/cm) was assessed by dual X-ray absorptiometry. Osteoporosis was diagnosed when BMD was 2.5 standard deviations below the mean peak value in young adults (T score, 22.5 SD). Patients with other pathology that may change the bone metabolism were excluded. Results Sixty patients (29 women and 31 men) were included in our study, with a mean age of 51.2 years (19-82 years). Thirteen patients had PBC (21.7%), thirteen suffering from hepatitis C (21.7%) and thirty four had hepatitis B (56.7%). Cirrhosis was found in 36.7% of patients (Child A: n=6, child B: n=10, Child C: n=6). No patient was taking calcium supplements, six of them had a history of fractures, and only four had a family history of osteoporosis. Eighteen patients had osteoporosis (30%), eighteen had osteopenia (30%) and 24 patients had normal bone density. Osteoporosis was found in 27% of patients with hepatitis B, 30% of patients with hepatitis C and in 70% of patients with PBC. The bone loss was associated with advanced age (54.5±12, 87 VS 46.2±16 years, p=0.03), with a low body mass index (23.6±4,7 vs 26,67±6 kg/m 2, p=0.0038) and with a low albumin levels (33.6±6 vs 38.2±5.36 g/l, p=0.004). It was also significantly associated with the presence of esophageal varices (p=0.02) and PBC (p=0.04). Conclusions Osteoporosis is effectively a complication of chronic liver disease. Cholestasis in addition to advanced age, low body mass index, low albumin level and the presence of esophageal varices are risk factors of osteoporosis in chronic liver disease. Disclosure of Interest None Declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.