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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 9 patients with pulmonary hypertension complicating portal hypertension. The cause of portal hypertension was cirrhosis in 7 patients, nodular regenerative hyperplasia of the liver in 1, and portal vein obstruction in 1. Six patients had been treated by portal-systemic shunting before the clinical onset of pulmonary hypertension. The interval between the first manifestation of portal hypertension and the recognition of pulmonary hypertension ranged from 2 to 15 years. Histologic examination in 1 of these patients revealed medial hypertrophy, concentric intimal proliferation, and plexiform lesions affecting the small pulmonary arteries. Pulmonary hypertension might result from the effect of a vasoconstrictive agent on the small pulmonary arteries or of a substance toxic to the walls of these vessels that is produced in the splanchnic territory, destroyed by the liver in normal subjects, and reaches the pulmonary arteries through portal-systemic shunts in these patients.
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PMID:Pulmonary hypertension complicating portal hypertension. 15 49

The state of pulmonary hemodynamics and the contractile function of the right parts of the heart were studied clinically and instrumentally in 35 patients with diffuse chronic pathological conditions of the liver. The lungs and heart were examined morphologically in 24 persons who had died from cirrhosis of the liver in the edematous-ascitic stage. Pulmonary hypertension was found to be directly dependent on the degree of the diffuse affection of the liver. Secondary-compensatory changes in the contractile function of the myocardium of the right parts of the heart in response to increase of pressure in the pulmonary artery in patients with cirrhosis of the liver were proved to occur.
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PMID:[State of the myocardial contractile function of the right sections of the heart and of the pulmonary hemodynamics in liver cirrhosis (based on clinical instrumental and morphological study data)]. 42 37

Morphological examinations of 24 autopsy cases of liver cirrhosis demonstrated the development of secondary postcapillary pulmonary hypertension with an increase of the muscular mass of the right ventricle and rearrangement of the blood vessels of pulmonary circulation. Most important morphological changes were observed in intraorgan veins and microcirculatory bed of the visceral pleura (particularly in the venular knee) indicating early reaction of the veins to hemodynamic disorders. It is suggested that hypervolemia in the pulmonary circulation system developing at the expence of blood discharge from the portal system into direct portopulmonary anastomoses plays an important role in the genesis of pulmonary hypertension in patients with hepatic cirrhosis.
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PMID:[Morphological characteristics of secondary pulmonary hypertension in liver cirrhosis]. 45 26

The pulmonary sections HE stained in 30 autopsy cases of cirrhosis were randomly reexamined. The distribution and degeneration of pulmonary arterioles and venules which were at alveolar level and the diameter of capillaries were observed; 10 autopsy cases of other diseases were examined as control. The results showed tricuspid orifices were dilated in 20% of autopsies; Both lungs were heavier than those in the control group, pulmonary congestion were in 100% of autopsied lungs. Pulmonary artery degeneration occurred in 16.6%, the number of pulmonary arterioles increased in 73.0%, the hypertrophic dilatation and increasing number of pulmonary arterioles in 33.3%; local spider in pulmonary pleura in 20%. We conclude that above findings will be helpful to the indirect diagnosis of intra-pulmonary shunt and pulmonary hypertension.
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PMID:[The pathological changes in pulmonary vessels complicated by cirrhosis with anatomicopathological analysis of 30 cases]. 139 98

The paper presents clinical and instrumental evidence on 47 patients with hepatic cirrhosis. The revealed ventilatory disorders and worse bronchial permeability closely correlated with the degree of pulmonary hypertension which in its turn depended on portal hypertension degree. Pulmonary hypertension decreased with a decline in the activity of the pathological process in the liver due to treatment. External respiration insufficiency observed in hepatic cirrhosis contributes to the onset of arterial hypoxemia and hypoxic impairment of the liver activating in it a pathological process. It is recommended that such patients should receive a combined treatment incorporating oxygen therapy, calcium antagonists, antioxidants.
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PMID:[Study of the right heart and external respiratory functions in patients with liver cirrhosis by Doppler echocardiography]. 176 48

The data obtained during the complex clinical and instrumental investigation of the hemodynamics in patients with the syndrome of portal and pulmonary hypertension against the background of acute drug tests with nitrosorbide, corinfar and obsidan, are presented. By using modern ultrasound and rheographic techniques, the degree and the relationship of portal and pulmonary hypertensions in patients with chronic hepatitis and cirrhosis of the liver are evaluated, the criteria of their early diagnosis are characterized. There was shown a positive action on the renal blood flow of nitrosorbide, an improvement of the pulmonary hemodynamics in patients with diseases of the liver against the background of corinfar exerting no influence on the hepatic blood flow. Obsidan induced a significant decrease of both portal and pulmonary hypertensions, normalization of the total hemodynamics thereby producing the greatest positive effect.
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PMID:[The effect of nitrosorbide, korinfar and obzidan on the hemodynamics of patients with chronic hepatitis and liver cirrhosis based on the data acute drug trials]. 180 Jan 53

We evaluated 77 patients with symptomatic mitral stenosis for balloon valvuloplasty. Five patients were excluded from the procedure due to the presence of intra-atrial thrombi or mitral valve endocarditis as detected by 2D echocardiography. The mean age of the 72 treated patients was 38 +/- 11 years, 68 were NYHA functional class II or IV: only 6 patients had valvular calcification. Three patients had severe liver failure, 2 were chronic alcoholics, one had liver cirrhosis, 2 had severe weight loss and 13 had pulmonary hypertension at systemic levels. 69 patients had a technically adequate procedure, one patient died, 1 developed cardiac tamponade and 1 failed. Mitral valve area increased from 0.93 +/- 0.34 to 2.38 +/- 0.67 cm2. Mitral incompetence increased in only 16 patients. After a mean follow up period of 15 +/- 5 months (range 8 to 27), 56 patients remained in FC I or II. Mitral valve area remained satisfactory in 54 patients. Mitral valve anatomy evaluated by echocardiography is helpful to predict immediate and late outcome. We conclude that balloon mitral valvuloplasty is the first choice for patients with severe symptomatic mitral stenosis.
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PMID:[Percutaneous mitral valvuloplasty as a treatment of choice for mitral stenosis. Immediate results and long-term follow-up]. 184 2

Detailed examination of hemodynamics in patients with portal and pulmonary hypertension was performed upon acute drug tests and course administration of nitrosorbide++, corinfar and propranolol. Ultrasound and rheography investigations were employed to elucidate the relations between portal and pulmonary hypertension in cirrhosis patients. Criteria of early diagnosis are discussed. Nitrosorbide++ produced positive effect on hepatic blood flow, corinfar improved pulmonary hemodynamics in lack of its influence on hepatic blood flow, while propranolol resulted in the drop of both portal and pulmonary hypertension, normalization of general hemodynamics.
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PMID:[Drug therapy of pulmonary and portal hypertension in liver cirrhosis]. 187 66

To determine the clinical, laboratory and hemodynamic profile in patients with primary pulmonary hypertension and associated portal hypertension, 7 new cases and 71 previously reported cases were analyzed. There was no gender predilection and the average age at diagnosis was 41 years. Liver cirrhosis was the most frequent cause of hypertension (82%) and a surgical portosystemic shunt was present in 29%. Almost invariably, portal hypertension either preceded or was diagnosed concurrently with pulmonary hypertension, favoring the hypothesis that in portal hypertension, the pulmonary vasculature may be exposed to vasoactive substances normally metabolized or produced by the diseased liver, possibly inducing vasoconstriction or direct toxic damage to the pulmonary arteries. Clinically, exertional dyspnea was the most frequent presenting symptom (81%); other symptoms, such as syncope, chest pain and fatigue, were present in less than 33%. An accentuated pulmonary component of the second heart sound (82%) and a systolic murmur (69%) were the most common physical findings. At least 75% of these patients had evidence of pulmonary hypertension on electrocardiography (right ventricular hypertrophy) or roentgenography (cardiomegaly or dilated main pulmonary arteries, or both). Hemodynamic findings included severe pulmonary hypertension (mean pulmonary artery pressure 59 +/- 19 mm Hg) with normal pulmonary capillary wedge pressure and cardiac output. Treatment was basically palliative and the mean and median survival times were 15 and 6 months, respectively. In brief, on the basis of clinical presentation and laboratory features, patients with combined primary pulmonary hypertension and portal hypertension seldom represent a diagnostic challenge. Further research is needed on treatment, which remains palliative. The survival rate is poor and worse than that seen in isolated primary pulmonary hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Association between primary pulmonary hypertension and portal hypertension: analysis of its pathophysiology and clinical, laboratory and hemodynamic manifestations. 199 8

A 56-year-old male with moderate pulmonary hypertension associated with liver cirrhosis was treated successfully by long term oxygen and vasodilator therapy. Improvement of pulmonary hypertension and clinical symptoms were proved by chest X-ray, ECG, echocardiography and right heart catheterization. Hegglin's phenomenon confirmed by phono- and mechanocardiography may suggest a hyperkinetic state as well as the so-called "energischemetabolische Herzinsufficienz" related to liver cirrhosis. The patient was treated for 18 months. After 2 months of therapy the patient became asymptomatic during modest daily activity, and apparent improvements of hemodynamic parameters were observed thereafter. Long term oxygen and vasodilator therapy in this patient with pulmonary hypertension associated with liver cirrhosis proved as effective as it has been in patients with primary pulmonary hypertension.
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PMID:[Favorable effect of long-term oxygen and vasodilator therapy in a patient with pulmonary hypertension associated with liver cirrhosis]. 211 94


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