Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts

Richard A. Santa-Cruz, Matthew D. Pearson, Mauricio G Cohen, Roshan Shrestha, Park W. Willis IV, Alan Hinderliter, Venu Menon

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Intrapulmonary shunting (IPS) is a well-described phenomenon in chronic liver disease but its significance is not known. Hypothesis: The study was undertaken to enhance our understanding of the characteristics and prevalence of IPS. Methods: We retrospectively studied 204 consecutive patients with end-stage chronic liver disease who underwent a dobutamine stress echocardiogram, along with a saline contrast bubble study, as part of their pretransplant evaluation. Results: Intrapulmonary shunting of any degree was present in 56.4% of patients. Patients with IPS were more likely to report alcohol use and less likely to have diabetes mellitus. Patients in Child-Pugh classification C were more likely to have IPS than those with classification A or B. The resting room air PaO2 levels were significantly lower in patients with grade 3-4 IPS than in those with grade 1-2. Elevated estimated pulmonary systolic pressure on echocardiography was more prevalent in patients with than in those without IPS. Conclusions: A majority of patients with end-stage chronic liver disease undergoing transplant evaluation have IPS. There are important baseline differences between patients with and without IPS. The presence of IPS is associated with increased severity of chronic liver disease. Further study is required to define the prognostic significance of IPS and its impact on future liver transplantation.

Original languageEnglish
Pages (from-to)437-441
Number of pages5
JournalClinical Cardiology
Volume28
Issue number9
StatePublished - Sep 1 2005
Externally publishedYes

Fingerprint

Liver Diseases
Chronic Disease
End Stage Liver Disease
Dobutamine
Liver Transplantation
Echocardiography
Diabetes Mellitus
Air
Alcohols
Blood Pressure
Transplants
Lung

Keywords

  • Chronic liver disease
  • Echocardiography
  • Intrapulmonary shunt
  • Pulmonary vasculature
  • Saline contrast

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Santa-Cruz, R. A., Pearson, M. D., Cohen, M. G., Shrestha, R., Willis IV, P. W., Hinderliter, A., & Menon, V. (2005). Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts. Clinical Cardiology, 28(9), 437-441.

Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts. / Santa-Cruz, Richard A.; Pearson, Matthew D.; Cohen, Mauricio G; Shrestha, Roshan; Willis IV, Park W.; Hinderliter, Alan; Menon, Venu.

In: Clinical Cardiology, Vol. 28, No. 9, 01.09.2005, p. 437-441.

Research output: Contribution to journalArticle

Santa-Cruz, RA, Pearson, MD, Cohen, MG, Shrestha, R, Willis IV, PW, Hinderliter, A & Menon, V 2005, 'Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts', Clinical Cardiology, vol. 28, no. 9, pp. 437-441.
Santa-Cruz RA, Pearson MD, Cohen MG, Shrestha R, Willis IV PW, Hinderliter A et al. Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts. Clinical Cardiology. 2005 Sep 1;28(9):437-441.
Santa-Cruz, Richard A. ; Pearson, Matthew D. ; Cohen, Mauricio G ; Shrestha, Roshan ; Willis IV, Park W. ; Hinderliter, Alan ; Menon, Venu. / Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts. In: Clinical Cardiology. 2005 ; Vol. 28, No. 9. pp. 437-441.
@article{06aae25b4fce4ab39eee864404ef48c3,
title = "Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts",
abstract = "Background: Intrapulmonary shunting (IPS) is a well-described phenomenon in chronic liver disease but its significance is not known. Hypothesis: The study was undertaken to enhance our understanding of the characteristics and prevalence of IPS. Methods: We retrospectively studied 204 consecutive patients with end-stage chronic liver disease who underwent a dobutamine stress echocardiogram, along with a saline contrast bubble study, as part of their pretransplant evaluation. Results: Intrapulmonary shunting of any degree was present in 56.4{\%} of patients. Patients with IPS were more likely to report alcohol use and less likely to have diabetes mellitus. Patients in Child-Pugh classification C were more likely to have IPS than those with classification A or B. The resting room air PaO2 levels were significantly lower in patients with grade 3-4 IPS than in those with grade 1-2. Elevated estimated pulmonary systolic pressure on echocardiography was more prevalent in patients with than in those without IPS. Conclusions: A majority of patients with end-stage chronic liver disease undergoing transplant evaluation have IPS. There are important baseline differences between patients with and without IPS. The presence of IPS is associated with increased severity of chronic liver disease. Further study is required to define the prognostic significance of IPS and its impact on future liver transplantation.",
keywords = "Chronic liver disease, Echocardiography, Intrapulmonary shunt, Pulmonary vasculature, Saline contrast",
author = "Santa-Cruz, {Richard A.} and Pearson, {Matthew D.} and Cohen, {Mauricio G} and Roshan Shrestha and {Willis IV}, {Park W.} and Alan Hinderliter and Venu Menon",
year = "2005",
month = "9",
day = "1",
language = "English",
volume = "28",
pages = "437--441",
journal = "Clinical Cardiology",
issn = "0160-9289",
publisher = "John Wiley and Sons Inc.",
number = "9",

}

TY - JOUR

T1 - Clinical predictors and characteristics of patients with chronic liver disease and intrapulmonary shunts

AU - Santa-Cruz, Richard A.

AU - Pearson, Matthew D.

AU - Cohen, Mauricio G

AU - Shrestha, Roshan

AU - Willis IV, Park W.

AU - Hinderliter, Alan

AU - Menon, Venu

PY - 2005/9/1

Y1 - 2005/9/1

N2 - Background: Intrapulmonary shunting (IPS) is a well-described phenomenon in chronic liver disease but its significance is not known. Hypothesis: The study was undertaken to enhance our understanding of the characteristics and prevalence of IPS. Methods: We retrospectively studied 204 consecutive patients with end-stage chronic liver disease who underwent a dobutamine stress echocardiogram, along with a saline contrast bubble study, as part of their pretransplant evaluation. Results: Intrapulmonary shunting of any degree was present in 56.4% of patients. Patients with IPS were more likely to report alcohol use and less likely to have diabetes mellitus. Patients in Child-Pugh classification C were more likely to have IPS than those with classification A or B. The resting room air PaO2 levels were significantly lower in patients with grade 3-4 IPS than in those with grade 1-2. Elevated estimated pulmonary systolic pressure on echocardiography was more prevalent in patients with than in those without IPS. Conclusions: A majority of patients with end-stage chronic liver disease undergoing transplant evaluation have IPS. There are important baseline differences between patients with and without IPS. The presence of IPS is associated with increased severity of chronic liver disease. Further study is required to define the prognostic significance of IPS and its impact on future liver transplantation.

AB - Background: Intrapulmonary shunting (IPS) is a well-described phenomenon in chronic liver disease but its significance is not known. Hypothesis: The study was undertaken to enhance our understanding of the characteristics and prevalence of IPS. Methods: We retrospectively studied 204 consecutive patients with end-stage chronic liver disease who underwent a dobutamine stress echocardiogram, along with a saline contrast bubble study, as part of their pretransplant evaluation. Results: Intrapulmonary shunting of any degree was present in 56.4% of patients. Patients with IPS were more likely to report alcohol use and less likely to have diabetes mellitus. Patients in Child-Pugh classification C were more likely to have IPS than those with classification A or B. The resting room air PaO2 levels were significantly lower in patients with grade 3-4 IPS than in those with grade 1-2. Elevated estimated pulmonary systolic pressure on echocardiography was more prevalent in patients with than in those without IPS. Conclusions: A majority of patients with end-stage chronic liver disease undergoing transplant evaluation have IPS. There are important baseline differences between patients with and without IPS. The presence of IPS is associated with increased severity of chronic liver disease. Further study is required to define the prognostic significance of IPS and its impact on future liver transplantation.

KW - Chronic liver disease

KW - Echocardiography

KW - Intrapulmonary shunt

KW - Pulmonary vasculature

KW - Saline contrast

UR - http://www.scopus.com/inward/record.url?scp=24344472535&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24344472535&partnerID=8YFLogxK

M3 - Article

C2 - 16250268

AN - SCOPUS:24344472535

VL - 28

SP - 437

EP - 441

JO - Clinical Cardiology

JF - Clinical Cardiology

SN - 0160-9289

IS - 9

ER -