Abstract
Background and Aims There are few studies on the prevalence and clinical characteristics of portopulmonary hypertension (POPH) in patients with portal hypertension. In addition, invasive right heart catheterization further limits the clinical diagnosis of POPH patients. Methods From January 2018 to December 2019, 1004 patients with portal hypertension were treated in the Department of Hepatology, the First Hospital of Jilin University. Based on the inclusion and exclusion criteria, 188 patients with portal hypertension were finally included. We collected complete clinical data, laboratory examinations, and imaging examinations. Patients were divided into a POPH group and a non-POPH group based on echocardiographic results. We calculated the prevalence of POPH in patients with portal hypertension. The differences in clinical characteristics of the two groups of patients were compared. Results The prevalence of POPH in patients with portal hypertension was 2.8%. Among the 188 patients with portal hypertension with fingertip oxygen saturation < 95% at rest, 28 patients had POPH (12 males and 16 females), with an average age of 63 ± 8, and 160 patients did not have POPH (110 males, 50 women), with an average age of 59 ± 11. The proportion of women in the POPH group (P < 0.01) and patients without liver cancer (P = 0.044) was high. Compared to patients without POPH, patients with POPH had lower hemoglobin (related to the severity of anemia, P < 0.01), higher creatinine (P < 0.05), and lower partial pressure of oxygen and carbon dioxide (P < 0.05). Patients with POPH had a higher incidence of atrial enlargement, ventricular enlargement, mitral valve regurgitation, tricuspid regurgitation, pulmonary artery widening, pericardial effusion, and aortic regurgitation than those without POPH. The risk of POPH did not increase with the aggravation of the Child-Pugh classification. Conclusion The prevalence of POPH in patients with portal hypertension is 2.8%. The proportion of women and nonliver cancer in POPH patients was higher than that in non-POPH patients. In addition, the POPH group had higher creatinine and lower hemoglobin, and echocardiography showed that POPH patients had more cardiac structural changes. In patients with portal hypertension, the risk in patients with POPH has nothing to do with the Child-Pugh classification and MELD score.
Highlights
Portopulmonary hypertension is defined as pulmonary hypertension formed on the basis of portal hypertension, which is common in liver cirrhosis, bile duct obstruction, and cholestatic diseases
From January 2018 to December 2019, 188 patients with portal hypertension who were admitted to the Department of Hepatology, the First Hospital of Jilin University, whose fingertip oxygen saturation was less than 95%, were enrolled in this research (Figure 1)
The proportion of female patients and patients without liver cancer in the portopulmonary hypertension (POPH) group was higher than that in the non-POPH group, and there was no significant difference in other aspects (Table 1)
Summary
Portopulmonary hypertension is defined as pulmonary hypertension formed on the basis of portal hypertension, which is common in liver cirrhosis, bile duct obstruction, and cholestatic diseases. There are few studies on the prevalence and clinical characteristics of portopulmonary hypertension (POPH) in patients with portal hypertension. Invasive right heart catheterization further limits the clinical diagnosis of POPH patients. We calculated the prevalence of POPH in patients with portal hypertension. Compared to patients without POPH, patients with POPH had lower hemoglobin (related to the severity of anemia, P < 0:01), higher creatinine (P < 0:05), and lower partial pressure of oxygen and carbon dioxide (P < 0:05). The prevalence of POPH in patients with portal hypertension is 2.8%. In patients with portal hypertension, the risk in patients with POPH has nothing to do with the Child-Pugh classification and MELD score
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