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)

Brain natriuretic peptide (BNP) is a recently discovered peptide, secreted by the atria and ventricles in response to parietal distension. It was recently proposed as a screening test for left ventricular failure. The authors assayed this peptide at rest in 37 patients with chronic heart failure due to left ventricular systolic dysfunction and another 20 patients with various diseases (respiratory failure, cirrhosis, heart transplantation, "diastolic" heart failure) but normal left ventricular systolic function. A significant increase compared to normal values was observed not only in the group of heart failure patients, but also in patients with all other diseases. BNP was significantly higher in NYHA class IV patients. The relationship between plasma BNP levels and ejection fraction was not significant. On the other hand, a good correlation was observed between BNP and left ventricular filling parameters evaluated by cardiac Doppler: E wave deceleration time (r = -0.53, p = 0.001), E/A ratio: r = 0.57 p = 0.005) or VO2 max (r = -0.55, p < 0.005).
Ann Cardiol Angeiol (Paris) 1999 Sep
PMID:[Brain natriuretic peptide (BNP) in coronary insufficiency: relationship with left ventricular filling and exercise tolerance]. 1255 77

Although it is recognized that hepatobiliary scan is of value in assessing postoperative complications of biliary surgery or cadaveric whole liver transplantation, there have been few reports regarding its usefulness following living donor liver transplantation. We performed living donor liver transplantation in a patient with biliary cirrhosis due to hepatolithiasis, using a right lobe graft from her sister. On the 15th postoperative day, bile discharge appeared from the operative wound. The leakage point could not be identified by computed tomography and cholangiography from the biliary drainage catheter. Hepatobiliary scan with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) demonstrated biliary extravasation from the left side of the anastomosis of the hepatico-jejunostomy, indicating biliary leakage from the anastomosis. Conservative therapy was continued because the radioisotope flowed smoothly into the reconstructed jejunum and the biliary drainage catheter, and the leakage was stopped on the 63th postoperative day. Hepatobiliary scan is useful in determining the therapeutic plan as well as detection of bile leakage and identification of leakage points after living donor liver transplantation.
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PMID:Bile leakage after living donor liver transplantation demonstrated with hepatobiliary scan using 9mTc-PMT. 1457 89

Amino acids are the "alphabet" of protein structure, determining many of the properties of proteins. Amino acids are rapidly absorbed and readily available in the blood. In the cell, amino acids maintain protein stores and counteract hormone-mediated catabolic stimuli. Thus, amino acid supplementation may be effective in counteracting the metabolic and morphologic consequences of the hypercatabolic state of chronic diseases such as heart failure, diabetes mellitus, or liver cirrhosis.
Am J Cardiol 2004 Apr 22
PMID:Amino acids: chemistry and metabolism in normal and hypercatabolic states. 1509 97

The effect of gender on the QT interval in patients with cirrhosis before and after liver transplantation and the relation between the QT interval and changes in gender hormones after liver transplantation were assessed. The study showed that (1) physiologic gender difference in the QTc interval is abolished in cirrhosis, and it is not restored after liver transplantation, and (2) gender hormone concentrations had no effect on the QTc interval.
Am J Cardiol 2005 Mar 01
PMID:Effect of cirrhosis and liver transplantation on the gender difference in QT interval. 1572 Nov 25

A 51-year-old woman was admitted with intractable congestive heart failure and progressive anemia. She had undergone mitral valve replacement for mitral regurgitation at age 23 years. Subsequently, her mitral prosthesis was replaced twice due to thrombotic stack and valve insufficiency. Signs of congestive heart failure became evident at age 46 years. Gastrointestinal endoscopy revealed esophageal varices, which were treated by endoscopic variceal ligation. Cardiac catheterization disclosed elevated pulmonary capillary wedge pressure (mean 16 mmHg), right atrial pressure (mean 15 mmHg), and hepatic vein wedge pressure (mean 15 mmHg). She died at age 53 years. Autopsy showed severe congestive liver but not liver cirrhosis. Esophageal varices may progress in spite of the absence of porto-systemic pressure gradient in patients with severely high venous pressure.
J Cardiol 2005 Apr
PMID:Esophageal varices without portosystemic venous pressure gradient in a patient with post-pericardiotomy constrictive pericarditis: a case report. 1587 38

A 55-year-old man was admitted with a four-month history of lethargy, dyspnea and ascites. An idiopathic liver cirrhosis was suspected to be responsible for these symptoms and for elevated hepatic enzymes on blood tests. A few months before he had an angioplasty on the left anterior descending artery for an acute coronary syndrome (ACS). The intervention was complicated by coronary perforation which required the implantation of a polytetrafluoroethylene-covered (PTFE) stent to seal the rupture. On admission, pressure measurements during cardiac catheterism revealed a typical right ventricular dip-plateau consistent with the diagnosis of constrictive pericarditis (CP). Magnetic resonance imaging (RMI) showed localized pericardial thickening next to the right ventricle. We suspect hemopericardium, due to coronary perforation, is responsible for constrictive pericarditis. This mid-term complication of coronary rupture has not been reported before and should be suspected in this particular clinical setting.
Int J Cardiol 2005 Sep 15
PMID:An unusual mid term complication of coronary rupture. 1601 14

We investigated the prevalence of intrapulmonary shunts in 82 patients with hepatic cirrhosis referred for echocardiography as part of liver transplantation evaluation. Intrapulmonary shunts were present in 49 of 82 patients (60%). Baseline characteristics were similar in patients with and without intrapulmonary shunts. Mean follow up was 41 +/- 15 months in patients with intrapulmonary shunts and 42 +/- 15 months in patients without intrapulmonary shunts (P not significant). At follow up, 8 of 49 patients (16%) with intrapulmonary shunts and 4 of 33 patients (12%) without intrapulmonary shunts had died (P not significant).
Cardiol Rev
PMID:Prevalence and prognosis of intrapulmonary shunts in patients with hepatic cirrhosis. 1649 41

With the wider use of imaging and interventional techniques that require the use of iodinated contrast media in seriously ill patients, many clinical situations occur where patients may be at increased risk for contrast-induced nephropathy (CIN). There is little guidance for clinicians in these areas. The aim of this review is to assess the available literature. Acute renal failure is a common complication following coronary artery bypass surgery, and exposure to contrast medium may increase the risk for this condition, although there is insufficient evidence to make a definitive statement. Evidence is also limited for patients with liver disease: in those undergoing transarterial chemoembolization, cirrhosis may be a risk factor for renal failure. There is some evidence that periprocedural hypotension may be a risk factor for CIN after percutaneous coronary intervention, but no published information was identified on the significance of shock or hypotension in other groups of patients. The published evidence on the risk of CIN in renal transplant recipients is inconsistent. In emergency situations, the course of action is usually dictated by clinical circumstances; the renal status of a patient is likely to be unknown and it is important to ensure adequate volume expansion, especially after the procedure. In all clinical situations that are potentially associated with a high risk for CIN, the decision to administer contrast medium is a matter for clinical judgment, based on the clinical status of the patient and the expected benefits of the investigation or procedure.
Am J Cardiol 2006 Sep 18
PMID:High-risk situations and procedures. 1694 79

A 58 year old man with history of cirrhosis presented with Vibrio vunificus sepsis. The patient developed multiorgan failure despite appropriate antibiotic therapy and fluid resuscitation. The patient developed moderate hypothermia. Electrocardiography showed Osborn wave. Osborn wave is commonly seen in accidental hypothermia. Although sepsis is known to cause hypothermia, Osborn wave in sepsis is not widely appreciated.
Int J Cardiol 2007 Jan 18
PMID:Osborn wave in hypothermia from Vibrio vunificus sepsis unrelated to exposure. 1704 85

The hyperdynamic circulation associated with cirrhosis is typically characterized by high cardiac output and low systemic and pulmonary vascular resistance (PVR). Approximately 4% of cirrhotic patients develop portopulmonary hypertension, which is an important predictor of hemodynamic instability after orthotopic liver transplantation. Doppler estimation of pulmonary artery systolic pressure (PASP) is used as a screening test for the presence of portopulmonary hypertension. We tested the accuracy of a noninvasive measurement of PVR (ratio of peak tricuspid regurgitant velocity [TRV] to right ventricular outflow tract velocity time integral [VTI RVOT]) to detect increased PVR in a population before liver transplantation. We compared test characteristics of the TRV/VTI RVOT ratio to echocardiographically derived PASP for detection of invasively measured PVR >1.5 Wood units. There was no significant correlation between Doppler-derived PASP and invasively measured PVR. There was a moderate and significant correlation between TRV/VTI RVOT ratio and invasively measured PVR. Compared with Doppler-derived PASP, the TRV/VTI RVOT ratio was a more accurate test for PVR >1.5 Wood units. Using a cut-off value of TRV/VTI RVOT >0.12, the sensitivity and negative predictive value for PVR >1.5 Wood units were 100%. In conclusion, the TRV/VTI RVOT ratio is a more accurate screening test for the presence of portopulmonary hypertension than PASP in patients undergoing orthotopic liver transplantation. Routine use of this ratio may decrease the need for invasive hemodynamic assessment in this patient population.
Am J Cardiol 2008 Jan 15
PMID:Accuracy of Doppler-estimated pulmonary vascular resistance in patients before liver transplantation. 1817 18


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