In HCV-related Liver Cirrhosis, Local Pulse Wave Velocity Increases and in Decompensated Patients Correlates with Poorer Survival

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Mar 20

PMID 30889181

Citations 6

Authors

Chien-Hao Huang

Lung-Sheng Wu

Wen-Juei Jeng

Yu-Fu Cheng

Yu-Shien Ko

I-Shyan Sheen

Chun-Yen Lin

Affiliations

Soon will be listed here.

Abstract

Background: Cirrhotic cardiomyopathy (CCM) refers to cardiac dysfunction in patients with liver cirrhosis, in the absence of other known cardiac disease.

Methods: Control group and patients diagnosed of liver cirrhosis without known cardiac disease or hepatocellular carcinoma were enrolled for this clinical observation study. Patients with diabetes mellitus, hypertension were excluded. Absolute global longitudinal strain, one-point carotid pulse wave velocity (one-point PWV) and various parameters were measured in resting status.

Results: There were 29 participants in the control group and 80 patients in the liver cirrhosis group. 27.8% of cirrhotic patients presented with normal systolic but abnormal diastolic functions and QTc prolongation that were compatible with CCM. 34.2% of cirrhotic patients presented with diastolic dysfunction in resting state comparing to 24.1% in control group. Systolic functions did not show conspicuous difference between cirrhosis and control group nor between compensated and decompensated cirrhosis, neither. Furthermore, one-point PWV was significantly higher in liver cirrhosis than in control group and higher in CCM than in non-CCM patients. One-point PWV predicted CCM and diastolic dysfunction in cirrhosis. Most importantly, its value > 1370cm/s predicted overall mortalities in decompensated cirrhosis (multivariable Cox analysis OR = 6.941) in addition to CTP score specifically in HCV related cirrhotic patients (AUC = 0.817).

Conclusions: In patients with cirrhosis, 27.8% were diagnosed with CCM by resting cardiovascular parameters. One-point PWV increased in CCM, correlated with diastolic dysfunction. It also correlated with overall mortality in patients with hepatitis C virus (HCV) related decompensated cirrhosis. Further study may be needed to confirm its capability for assessing CV and mortality risks in HCV related decompensated cirrhotic patients.

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References

Chen Y, Chan A, Chan S, Chok S, Sharr W, Fung J . A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation. J Cardiol. 2015; 67(2):140-6. DOI: 10.1016/j.jjcc.2015.08.001. View

Mayet J, Hughes A . Cardiac and vascular pathophysiology in hypertension. Heart. 2003; 89(9):1104-9. PMC: 1767863. DOI: 10.1136/heart.89.9.1104. View

Turin T, Kita Y, Rumana N, Takashima N, Kadota A, Matsui K . Brachial-ankle pulse wave velocity predicts all-cause mortality in the general population: findings from the Takashima study, Japan. Hypertens Res. 2010; 33(9):922-5. DOI: 10.1038/hr.2010.103. View

Novo G, Macaione F, Giannitrapani L, Minissale M, Bonomo V, Indovina F . Subclinical cardiovascular damage in patients with HCV cirrhosis before and after treatment with direct antiviral agents: a prospective study. Aliment Pharmacol Ther. 2018; 48(7):740-749. DOI: 10.1111/apt.14934. View

Ishizaka N, Ishizaka Y, Takahashi E, Tooda E, Hashimoto H, Nagai R . Association between hepatitis C virus seropositivity, carotid-artery plaque, and intima-media thickening. Lancet. 2002; 359(9301):133-5. DOI: 10.1016/s0140-6736(02)07339-7. View

Fridericia L . The duration of systole in an electrocardiogram in normal humans and in patients with heart disease. 1920. Ann Noninvasive Electrocardiol. 2003; 8(4):343-51. PMC: 7328879. DOI: 10.1046/j.1542-474x.2003.08413.x. View

Ross R . Atherosclerosis--an inflammatory disease. N Engl J Med. 1999; 340(2):115-26. DOI: 10.1056/NEJM199901143400207. View

Andersen U, Moller S, Bendtsen F, Henriksen J . Cardiac output determined by echocardiography in patients with cirrhosis: comparison with the indicator dilution technique. Eur J Gastroenterol Hepatol. 2003; 15(5):503-7. DOI: 10.1097/01.meg.0000059106.41030.8e. View

Pozzi M, Carugo S, Boari G, Pecci V, De Ceglia S, Maggiolini S . Evidence of functional and structural cardiac abnormalities in cirrhotic patients with and without ascites. Hepatology. 1997; 26(5):1131-7. DOI: 10.1002/hep.510260507. View

10.

Arvaniti V, DAmico G, Fede G, Manousou P, Tsochatzis E, Pleguezuelo M . Infections in patients with cirrhosis increase mortality four-fold and should be used in determining prognosis. Gastroenterology. 2010; 139(4):1246-56, 1256.e1-5. DOI: 10.1053/j.gastro.2010.06.019. View

11.

Stefanadis C, Dernellis J, Tsiamis E, Stratos C, Diamantopoulos L, Michaelides A . Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease. Eur Heart J. 2000; 21(5):390-6. DOI: 10.1053/euhj.1999.1756. View

12.

Schuppan D, Afdhal N . Liver cirrhosis. Lancet. 2008; 371(9615):838-51. PMC: 2271178. DOI: 10.1016/S0140-6736(08)60383-9. View

13.

Cheung M, Walker A, Hudson B, Verma S, McLauchlan J, Mutimer D . Outcomes after successful direct-acting antiviral therapy for patients with chronic hepatitis C and decompensated cirrhosis. J Hepatol. 2016; 65(4):741-747. DOI: 10.1016/j.jhep.2016.06.019. View

14.

Torregrosa M, Aguade S, Dos L, Segura R, Gonzalez A, Evangelista A . Cardiac alterations in cirrhosis: reversibility after liver transplantation. J Hepatol. 2005; 42(1):68-74. DOI: 10.1016/j.jhep.2004.09.008. View

15.

Sampaio F, Pimenta J, Bettencourt N, Fontes-Carvalho R, Silva A, Valente J . Systolic dysfunction and diastolic dysfunction do not influence medium-term prognosis in patients with cirrhosis. Eur J Intern Med. 2014; 25(3):241-6. DOI: 10.1016/j.ejim.2014.01.011. View

16.

Becker M, Bilke E, Kuhl H, Katoh M, Kramann R, Franke A . Analysis of myocardial deformation based on pixel tracking in two dimensional echocardiographic images enables quantitative assessment of regional left ventricular function. Heart. 2006; 92(8):1102-8. PMC: 1861114. DOI: 10.1136/hrt.2005.077107. View

17.

Petta S, Maida M, Macaluso F, Barbara M, Licata A, Craxi A . Hepatitis C Virus Infection Is Associated With Increased Cardiovascular Mortality: A Meta-Analysis of Observational Studies. Gastroenterology. 2015; 150(1):145-155.e4. DOI: 10.1053/j.gastro.2015.09.007. View

18.

Tomiyama H, Arai T, Hirose K, Hori S, Yamamoto Y, Yamashina A . Hepatitis C virus seropositivity, but not hepatitis B virus carrier or seropositivity, associated with increased pulse wave velocity. Atherosclerosis. 2003; 166(2):401-3. DOI: 10.1016/s0021-9150(02)00388-x. View

19.

Wu V, Chen T, Wu M, Cheng C, Chen S, Chang C . Comparison of cardiovascular outcomes and all-cause mortality in patients with chronic hepatitis B and C: A 13-year nationwide population-based study in Asia. Atherosclerosis. 2018; 269:178-184. DOI: 10.1016/j.atherosclerosis.2018.01.007. View

20.

Garcia M, Palac R, Malenka D, Terrell P, Plehn J . Color M-mode Doppler flow propagation velocity is a relatively preload-independent index of left ventricular filling. J Am Soc Echocardiogr. 1999; 12(2):129-37. DOI: 10.1016/s0894-7317(99)70125-2. View