Abstract
Transjugular intrahepatic portosystemic shunts (TIPS) have become a widely accepted tool in the treatment of patients with symptomatic portal hypertension. The aim of our study was to assess glycogen phosphorylase BB (GPBB) concentration in relation to echocardiographic and haemodynamic parameters in patients before and after TIPS insertion. The study population consisted of 55 patients (38 men and 17 women, age 55.6±8.9 years, range 37-74 years) with liver cirrhosis treated with transjugular portosystemic shunting. GPBB, echocardiographic, and haemodynamic parameters were measured before TIPS insertion and 24 h after the procedure. GPBB concentrations were assessed using the Cardiac Array for Evidence Investigator protein biochip. Correlation between parameters was assessed using the Spearman's coefficient. Serum post-procedural GPBB concentrations were increased in comparison with baseline (5.58 vs. 2.67 μg/L, P<0.001). GPBB concentration after TIPS significantly correlated with baseline systemic vascular resistence (r=0.330; P=0.017) and cardiac index (r=0.313; P=0.025). GPBB concentration measurement may be a useful tool for monitoring myocardial ischemia during a TIPS procedure.
Highlights
Portal hypertension is the main cause for the development of esophago-gastric varices, ascites and hepatic nephropathy in liver cirrhosis
The study population consisted of 55 consecutive patients (38 men and 17 women, age 55.6± 8.9 years) with liver cirrhosis treated with elective transjugular portosystemic shunting
We have found an association between glycogen phosphorylase BB (GPBB) measured 24 h after Transjugular intrahepatic portosystemic shunts (TIPS) insertion with systemic vascular resistence (SVR) (Fig. 1) and cardiac index (CI) (Fig. 2) assessed before the procedure
Summary
Portal hypertension is the main cause for the development of esophago-gastric varices, ascites and hepatic nephropathy in liver cirrhosis. Huonker et al observed an increase in the left atrial diameter, left ventricular end diastolic volume, pulmonary capillary wedge pressure, right atrial pressure, cardiac output, and total pulmonary resistance after TIPS procedure[2]. These changes reflect diastolic dysfunction occurring after TIPS. Transjugular intrahepatic portosystemic shunts (TIPS) have become a widely accepted tool in the treatment of patients with symptomatic portal hypertension. The aim of our study was to assess glycogen phosphorylase BB (GPBB) concentration in relation to echocardiographic and haemodynamic parameters in patients before and after TIPS insertion. GPBB concentration measurement may be a useful tool for monitoring myocardial ischemia during a TIPS procedure
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More From: Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia
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