Left ventricle enlargement and increased systolic velocity in the mitral valve are indirect markers of the hepatopulmonary syndrome

Abstract

We confirmed that in patients with cirrhosis, the development of HPS is associated with higher cardiac output and hyperdynamic circulation. Left ventricle enlargement and higher systolic velocity in the mitral valve represent satisfactory indirect markers of HPS.

Role of angiogenic factors/cell adhesion markers in serum of cirrhotic patients with hepatopulmonary syndrome

“…It is an interesting observation that patients with HPS were significantly younger than patients without HPS. This is also described by Pouriki et al (19). In other studies HPS patients were younger than patients without the disorder, although the age difference was not statistically significant (18,20).…”

“…This is also described by Pouriki et al . . In other studies HPS patients were younger than patients without the disorder, although the age difference was not statistically significant .…”

“…In this study, patients were matched for severity and aetiology of liver disease. In most previous studies, no association between HPS and severity of liver disease was found (17)(18)(19)(20). In some studies however, a slight association between liver disease severity and clinical hypoxaemia is found: the risk seems to be highest in Child C patients (20)(21)(22)(23).…”

Differential diagnosis of hepatopulmonary syndrome (HPS): Portopulmonary hypertension (PPH) and hereditary hemorrhagic telangiectasia (HHT)

“…Furthermore, patients with chronic liver disease and diagnosed HPS showed a significantly greater left atrial volume compared to the control group (55.1 ± 7.5 ml and 37.1 ± 9.3 ml, A-aО 2 : alveolar-arterial oxygen gradient; РаО 2 : partial pressure of oxygen respectively, p < 0.05); the sensitivity was 86.3% and specificity -81.2% [35]. These results indicate that left atrial enlargement could be used as diagnostic criteria for HPS [35,36]. The disadvantage of two-dimensional transthoracic contrast echocardiography is the inability to determine the type of vascular anomaly that caused a pulmonary shunt [37].…”

Review article: Update on current and emergent data on hepatopulmonary syndrome

“…Remarkably, left atrial volume equal or greater than 50 mL was suggested as a strong echocardiographic predictor of HPS in patients with liver cirrhosis (area under the receiver operating characteristic curve: 0.903, sensitivity 86.3%, specificity 81.2%)[ 126 ]. Left ventricular enlargement was also proposed as an independent, indirect echocardiographic marker of HPS[ 127 ]. In addition, higher systolic myocardial velocity of the mitral valve measured by tissue Doppler imaging technique was independently associated with HPS (odds ratio: 1.428, 95%CI: 1.049-1.943, P = 0.026), a finding implying left ventricular systolic dysfunction[ 127 ].…”