With the development of progressive right ventricular dysfunction, pulmonary arterial hypertension (PAH) is one of the causes of type 2 cardiohepatic syndrome (CHS). Risk assessment, timely and effective management are crucial to improve survival in PAH. Thus, we aimed to evaluate the presence of CHS at diagnosis and its association with prognosis in patients with PAH. One hundred and eighteen consecutive incident patients with PAH between January 2013 and June 2021 were retrospectively included. The presence of CHS was assessed from blood tests taken during diagnostic evaluation and was defined as elevation of at least two of three cholestatic liver parameters; total bilirubin, alkaline phosphatase and gamma-glutamyl transferase. The primary endpoint was all-cause mortality. Patients were followed for a median period of 58 (32-96) months. 23.7% of the patients had CHS at diagnosis. Significantly more patients in CHS (+) group were in intermediate and high-risk categories according to 2015 ESC/ERS guideline, REVEAL 2.0 and REVEAL Lite 2 risk assessment methods ( = .02, .03 and <.001, respectively). The presence of CHS was identified as an independent predictor of mortality (HR: 2.17, 95% CI: 1.03-4.65, = .03) along with older age (HR: 2.89, 95% CI: 1.50-5.56, = .001) and higher WHO functional class (HR: 2.57, 95% CI: 1.07-6.22, = .03). To conclude, presence of CHS at diagnosis in patients with PAH was associated with severe disease and poor prognosis independent of other well known risk factors. As a simple and easy parameter to assess from routinely taken blood tests, CHS should be evaluated in patients with PAH.
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http://dx.doi.org/10.1080/00365513.2023.2225778 | DOI Listing |
J Clin Med
September 2024
Clinic of Cardiac Transplantation and Mechanical Circulatory Support, Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wroclaw, Poland.
: Multi-organ failure (MOF) often complicates advanced heart failure (HF), contributing to a poor prognosis. The Model of End-Stage Liver Disease 3.0 (MELD-3.
View Article and Find Full Text PDFDtsch Arztebl Int
August 2024
Department of Cardiology, LMU Klinikum, Ludwig Maximilian University of Munich, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany; Department of Cardiology and Angiology, University Heart Center Freiburg/Bad Krozingen, University Hospital Freiburg, Freiburg, Germany; Department of Cardiac and Vascular Surgery, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Mainz, Germany.
Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments.
Methods: This review is based on publications that were retrieved by a selective search in the PubMed database for randomized controlled trials (RCTs), observational studies, registry studies, expert recommendations, and current international guidelines.
Pharmacol Rep
April 2024
Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, Białystok, 15-222, Poland.
J Heart Lung Transplant
July 2024
Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany. Electronic address:
Background: Pulmonary hypertension (PH) can lead to congestive hepatopathy, known as cardiohepatic syndrome (CHS). Hepatic congestion is associated with increased liver stiffness, which can be quantified using shear wave elastography. We aimed to investigate whether hepatic shear wave elastography detects patients at risk in the early stages of PH.
View Article and Find Full Text PDFAm J Cardiol
February 2024
Department of The First Outpatient, General Hospital of Southern Theater Command, Guangzhou, China. Electronic address:
Heart failure (HF) can damage various organs, including the liver, a phenomenon known as "cardiohepatic syndrome." The latter is characterized by liver congestion and hepatic artery hypoperfusion, which can lead to liver damage. In this study, we aimed to assess liver damage quantitatively in chronic HF (CHF) with sound touch elastography (STE).
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