Assessment of pulmonary arterial stiffness in patients with cirrhosis: A prospective cohort study

Abstract

Introduction In the current literature, several studies show that PAS (pulmonary artery stiffness) is associated with RV (right ventricular) dysfunction, PAH (pulmonary arterial hypertension), and disease severity in subjects with structural cardiac disease, HIV (human immunodeficiency virus), and chronic lung disease. Hence, our main aim was to use PAS to show the early changes in the pulmonary vascular region in subjects with cirrhosis. Material and Methods In this prospective cross‐sectional study, 39 subjects who were being followed up with cirrhosis and 41 age‐ and sex‐matched healthy subjects were included in this study. For each case, the PAS value was obtained by dividing mean peak velocity of the pulmonary flow by the PfAT (pulmonary flow acceleration time). Results The measured PAS was 23.62 ± 5.87 (Hz/msn) in cirrhotic participants and 19.09 ± 4.16 (Hz/msn) in healthy cases (P < .001). We found a positive statistical significance between PAS and RVSP (right ventricle systolic pressure)/sPAP (systolic pulmonary arterial pressure) (r = .395; P = .013). PAS was an independent predictor that was associated with cirrhosis disease according to multivariate LR (logistic regression) analysis (OR: 1.209; 95% CI: 1.059–1.381; P = .005). Conclusion Based on the study results, we consider that PAS may help in the early detection of findings in the pulmonary vascular area, even if the RV function findings or sPAP is within the normal range.

Echocardiography Assessment of Cardiac Function in Adults Living with HIV: A Speckle Tracking Study in the Era of Antiretroviral Therapy

“…While there is no clear pathophysiologic explanation, early studies also reported isolated RV dysfunction in people living with HIV independent from pulmonary hypertension [21,22]. Moreover, an increased pulmonary arterial stiffness was observed in patients with HIV [23].…”

Evaluation of Pulmonary Arterial Stiffness in Mild COVID-19 Patients: A Pilot Prospective Study

“…Öz et al showed that PAS might be helpful in the early detection of abnormalities in the pulmonary vascular bed even while RV function or sPAP levels were normal in cirrhotic patients. 14 Another study found that PAS values increased in polycystic ovarian syndrome patients, and it was associated with high Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) levels. 15 In the same study, it was reported that the same patient group had reduced RV-PA coupling, which was an indication of PA compliance that played a signi cant role in the etiology of PAH.…”

Pulmonary transit time has close relation with pulmonary pulse wave transit time in normal subjects

“…RV‐PA coupling was calculated according to the following formulas: RV‐PA coupling(mm/mmHg) = TAPSE/MPAP (Prins et al, 2016). PAS (kHz/s) was calculated according to the following formula: PAS = MFS/AT PA (Abacioglu et al, 2021; Görgülü et al, 2003; Öz et al, 2021). Subsequently, the right superior pulmonary vein from the apical four‐chamber view was found by adjusting the position of the transducer, so that the pulmonary vein opening can be clearly displayed.…”

“…RV-PA coupling was calculated according to the following formulas: RV-PA coupling(mm/ mmHg) = TAPSE/MPAP (Prins et al, 2016). PAS (kHz/s) was calculated according to the following formula: PAS = MFS/AT PA (Abacioglu et al, 2021;Görgülü et al, 2003;Öz et al, 2021).…”