Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 1030 patients requiring thoracotomy over a 7-year period, 11 had cirrhosis of the liver. The disease was severe (Child class C) in four patients, two of whom had recent variceal bleeding. Control patients with normal liver function recovered from post-thoracotomy hepatic disturbance within a week, but the cirrhotic patients required 2-3 weeks to regain baseline function. Although there were no perioperative deaths among the cirrhotic patients, management of significant pleural effusions required diuretics and plasma or albumin supplementation. Presence of cirrhosis, even advanced disease, need not contraindicate thoracotomy with skilled postoperative management, but the poor overall prognosis in Child class C cirrhosis calls for careful assessment of surgical indication.
Scand J Thorac Cardiovasc Surg 1994
PMID:Thoracotomy in patients with liver cirrhosis. 793 5

Clinical observations over the past two decades have pointed to the relationship between heart disease and alcohol abuse, usually without evident malnutrition or cirrhosis. While the prevalence of heart failure in the alcoholic population is now known, subclinical abnormalities of left ventricular function in noncardiac alcoholics who were normotensive have a high prevalence with or without some degree of ventricular hypertrophy by echocardiogram. This is frequently a diastolic rather than systolic abnormality. Congestive cardiomyopathy is not infrequently associated with high diastolic arterial blood pressures. Intoxication itself may contribute to blood pressure elevation. Angina pectoris in the absence of significant coronary disease is another presentation. Although the history may not be readily obtained, the major diagnostic feature in this entity is the history of ethanol ingestion in intoxicating amounts for at least 10 years, often marked by periods of spree drinking. While the course of congestive cardiomyopathy may be progressively downhill in individuals who continue to be actively alcoholic after the onset of heart failure, in one series one third of the patients became abstinent. These patients had a 4 year mortality that was persistently one-sixth of the alcoholic group. Management of heart failure is traditional in these patients. Atrial arrhythmias have been shown to occur during the early ethanol withdrawal phase in patients without other clinical evidence of heart disease. Sudden death in a segment of the alcoholic population is considered arrhythmia related and is commonly associated with cigarette use. Identification of the addicted individual is the essential element to management.
Cardiovasc Drugs Ther 1994 Feb
PMID:Alcoholic cardiomyopathy. 808 32

A 55-year-old man with hepatic cirrhosis, gastroesophageal varices, ascites, slight abdominal pain, and transient encephalopathy experienced unexpected spontaneous relief of his symptoms during hospitalization. Percutaneous transhepatic portography showed an aneurysmal intrahepatic portosystemic venous shunt. Three years later, the shunt was still patent and had led to disappearance of the patient's varices and ascites. The patient remains stable 6 years later.
Cardiovasc Intervent Radiol
PMID:Spontaneous aneurysmal intrahepatic portosystemic venous shunt. 818 34

Between 1980 and 1990 transcaval liver resection with hepatoatrial anastomosis was performed in 17 patients with the Budd-Chiari syndrome. There were two early deaths (early mortality 11.7%). Hepatic function returned to normal and hepatosplenomegaly disappeared in all but two patients with preexisting cirrhosis. All survivors regained normal working capacity after the operation. During an average follow-up of 6 years (7 months to 11 years) there were three late deaths due to progression of the underlying disease. The actuarial 1-, 5-, and 10-year survivals were 82%, 76%, and 57%, respectively. Hepatoatrial anastomosis represents an optimal treatment for patients with the Budd-Chiari syndrome and obstruction of major hepatic veins. Patients with compression of the inferior vena cava, very common in this disease, were treated by simultaneous transcaval stenting. The late results are very satisfactory, with excellent quality of life. With adequate hepatic function, results of hepatoatrial anastomosis are superior to those of liver transplantation, which represents the only alternative for patients with the advanced form of the Budd-Chiari syndrome.
J Thorac Cardiovasc Surg 1993 Aug
PMID:Transcaval liver resection with hepatoatrial anastomosis for treatment of patients with the Budd-Chiari syndrome. Late results. 834 Oct 68

A 57-year-old woman presented with hepatic encephalopathy, cirrhosis, and a dual-channel portosystemic venous shunt (PSVS). The shunt was treated successfully by embolization with steel coils via retrograde systemic venous access. Encephalopathy resolved. This new approach is considered safer than the previously reported percutaneous transhepatic route or the mesenteric venous route, requiring a mini-laparotomy.
Cardiovasc Intervent Radiol
PMID:Therapeutic embolization of intrahepatic portosystemic shunts by retrograde transcaval catheterization. 840 89

The effects of torasemide (20 mg/day) and furosemide (50 mg/day), each given over 4 days, were compared in a randomized and crossover study carried out in seven patients with cirrhosis and tense ascites. Patients also received a low-sodium (40 mmol/day) diet and the aldosterone antagonist, potassium canrenoate (100 mg b.i.d.). Torasemide induced a remarkably higher natriuretic (120 +/- 15 vs. 33 +/- 6 mmol/day, p < 0.02) and diuretic (1450 +/- 63 vs. 900 +/- 58 ml, p < 0.005) effect than furosemide. Body weight loss was also significantly higher (2.5 +/- 1.6 vs. 0.2 +/- 1.3 kg, p < 0.01) during the torasemide period. Kaliuresis was similar during the two treatment periods, despite the striking differences observed in natriuresis. Neither torasemide nor furosemide induced any significant change in serum electrolyte or creatinine concentrations, or in ammonia levels. The results of this study indicate that torasemide is suitable for the treatment of sodium retention in patients with cirrhosis and ascites.
Cardiovasc Drugs Ther 1993 Jan
PMID:Torasemide in the treatment of patients with cirrhosis and ascites. 843 82

Rats with experimental liver cirrhosis have increased endothelin-1 (ET-1) plasma concentrations and show a tendency toward sodium and water retention. We therefore analyzed the renal ET system in cirrhotic rats and control rats, as the renal ET system is involved in the regulation of water and sodium excretion. Cirrhosis was induced by carbon tetrachloride (CCl4) administration. We analyzed the expression of ET receptor subtypes in the renal cortex and medulla using Scatchard analysis and receptor autoradiography, and measured plasma and renal tissue ET-1 concentrations using a specific radioimmunoassay. Furthermore, we analyzed the effects of the nonselective (A/B) ET receptor antagonist bosentan on water and sodium excretion and glomerular filtration rate. Our study revealed an overexpression of the ETB receptor in the renal medulla of rats with liver cirrhosis, whereas the density of ETB receptor in the cortex and the ETA receptor in the cortex and medulla were similar in both cirrhotic and control rats. Receptor autoradiography showed that the upregulation of medullary ETB in cirrhotic rats was due to an upregulation of ETB in the inner medullary collecting duct cells. The highest ET-1 concentrations were observed in the renal medulla of cirrhotic rats. Glomerular filtration rate decreased in cirrhotic rats but was not altered after bosentan treatment in cirrhotic and control rats. Bosentan decreased sodium excretion in both cirrhotic and control rats to a similar extent, whereas water excretion was reduced by bosentan only in cirrhotic rats. We therefore suggest that the upregulation of medullary ETB in cirrhotic rats is involved int he regulation of water excretion in rats with CCl4-induced cirrhosis.
J Cardiovasc Pharmacol 1995
PMID:Renal endothelin system in rats with liver cirrhosis. 858 36

Sympathetic nervous system activation has been documented in several cardiovascular disorders. In some, characterized by cardiac failure and portal hypertension accompanying hepatic cirrhosis, the sympathetic nervous stimulation is reflex and, to some extent, compensatory but has adverse consequences. For example, in cardiac failure, the sympathetic nerves of the heart are preferentially stimulated, providing adrenergic support to the failing myocardium but at the probable cost of arrhythmogenesis and progressive myocardial deterioration. The sympathetic activation present in patients with essential hypertension, which involves the sympathetic outflows to skeletal muscle, heart, and kidneys and is seen particularly in younger patients, differs from these examples in that the sympathetic nervous stimulation is apparently not reflex and the primary cause is unknown. There is, however, evidence that activation of forebrain pressor noradrenergic nuclei may be of importance as an underlying central nervous system mechanism. This sympathetic nervous stimulation in patients with essential hypertension, in addition to initiating the blood pressure elevation, may also contribute to the commonly associated metabolic abnormalities of insulin resistance and hyperlipidemia, with neural vasoconstriction having metabolic consequences, impairing glucose delivery and causing insulin resistance in muscle, and retarding postprandial clearing of lipids in liver. Trophic effects of sympathetic activation on cardiovascular growth are claimed but have yet to be demonstrated conclusively in humans.
J Cardiovasc Pharmacol 1995
PMID:Sympathetic nervous system: contribution to human hypertension and related cardiovascular diseases. 864 1

A 51-year-old man with posthepatitis cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for bleeding of recurrent esophageal varices. The patient had a coexisting, spontaneous, splenorenal shunt. He subsequently developed hepatic encephalopathy, presumably due to excessive portosystemic shunting. Since medical management resulted in no significant improvement, the splenorenal shunt was embolized from the jugular vein approach via renal vein access during temporary balloon occlusion. Within a few days, the patient's hepatic encephalopathy resolved. Twelve months later the patient showed no recurrence of encephalopathy and had maintained a patent TIPS.
Cardiovasc Intervent Radiol
PMID:Post-TIPS hepatic encephalopathy treated by occlusion balloon-assisted retrograde embolization of a coexisting spontaneous splenorenal shunt. 865 49

A patient with cardiac cirrhosis due to severe tricuspid regurgitation associated with a mitral valve lesion successfully underwent mitral and tricuspid valve replacement. Preoperative rest cure with liver supporting therapy for 5 months was used to maximize hepatic and cardiac function. Postoperatively, jaundice developed despite improvements in cardiac function. Plasma exchange was performed nine times over a period of 10 days with the liver function improved. He was discharged with New York Heart Association class I symptoms and normal liver function 2 months following surgery.
J Cardiovasc Surg (Torino) 1996 Jun
PMID:Successful surgical treatment of cardiac cirrhosis. Tricuspid surgery and plasma exchange. 869 69


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