Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt

Massimo Cazzaniga, Francesco Salerno, Giovanni Pagnozzi, Elena Dionigi, Stefania Visentin, Ilaria Cirello, Daniele Meregaglia, Antonio Nicolini

Research output: Contribution to journalArticle

Abstract

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is a treatment for portal hypertension-related complications. Accurate prediction of the outcome of patients treated with TIPS is important, because some patients have very short survival. Diastolic dysfunction is frequently observed in patients with cirrhosis. Aim: To investigate whether or not diastolic dysfunction can predict the outcome after TIPS. Methods: Echocardiography with Doppler exploration was performed before and 28 days after TIPS insertion in 32 patients with cirrhosis. Several echocardiographic measures, including the early maximal ventricular filling velocity/late filling velocity (E/A) ratio as indicative of diastolic function, as well as laboratory, clinical and demographic variables were evaluated as predictors of survival. Results: Univariate analysis revealed that the presence of diastolic dysfunction observed 28 days after TIPS (E/A ratio ≤1) and baseline model of end-stage liver disease score were related to survival. Multivariate analysis identified diastolic dysfunction as an independent predictor of death (RR 8.9, 95% CI 1.9 to 41.5, p = 0.005). During the first year of follow-up, six out of 10 patients with an E/A ratio ≤1 died, whereas all 22 patients with E/A ratio >1 survived. Conclusions: Diastolic dysfunction estimated using E/A ratio is a promising predictor of death in patients with cirrhosis who are treated with TIPS.

Original languageEnglish
Pages (from-to)869-875
Number of pages7
JournalGut
Volume56
Issue number6
DOIs
Publication statusPublished - Jun 2007

ASJC Scopus subject areas

  • Gastroenterology

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