Cardiovascular magnetic resonance demonstrates structural cardiac changes following transjugular intrahepatic portosystemic shunt.
Ulf K RadunskiJohannes KluweMalte KleinAntonio GalanteGunnar K LundChristoph SinningSebastian BohnenEnver TahirJitka StarekovaPeter BannasChristian StehningGerhard AdamAnsgar W LohseStefan BlankenbergKai MuellerleileDaniel BentenPublished in: Scientific reports (2021)
Transjugular intrahepatic portosystemic shunt (TIPS) reduces portal hypertension in patients with liver cirrhosis. The exact cardiac consequences of subsequent increase of central blood volume are unknown. Cardiovascular magnetic resonance (CMR) imaging is the method of choice for quantifying cardiac volumes and ventricular function. The aim of this study was to investigate effects of TIPS on the heart using CMR, laboratory, and imaging cardiac biomarkers. 34 consecutive patients with liver cirrhosis were evaluated for TIPS. Comprehensive CMR with native T1 mapping, transthoracic echocardiography, and laboratory biomarkers were assessed before and after TIPS insertion. Follow-up (FU) CMR was obtained in 16 patients (47%) 207 (170-245) days after TIPS. From baseline (BL) to FU, a significant increase of all indexed cardiac chamber volumes was observed (all P < 0.05). Left ventricular (LV) end-diastolic mass index increased significantly from 45 (38-51) to 65 (51-73) g/m2 (P = < 0.01). Biventricular systolic function, NT-proBNP, high-sensitive troponin T, and native T1 time did not differ significantly from BL to FU. No patient experienced cardiac decompensation following TIPS. In conclusion, in patients without clinically significant prior heart disease, increased cardiac preload after TIPS resulted in increased volumes of all cardiac chambers and eccentric LV hypertrophy, without leading to cardiac impairment during follow-up in this selected patient population.
Keyphrases
- left ventricular
- magnetic resonance
- heart failure
- cardiac resynchronization therapy
- hypertrophic cardiomyopathy
- acute myocardial infarction
- blood pressure
- end stage renal disease
- ejection fraction
- aortic stenosis
- newly diagnosed
- magnetic resonance imaging
- pulmonary artery
- pulmonary hypertension
- case report
- mass spectrometry
- peritoneal dialysis
- resistance training
- pulmonary arterial hypertension
- atrial fibrillation