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Region Hovedstaden - en del af Københavns Universitetshospital
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Cardiac Function in Patients with Early Cirrhosis during Maximal Beta-Adrenergic Drive: A Dobutamine Stress Study

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Abstract
Background and aim: Cardiac dysfunction in patients with early cirrhosis is debated. We investigated potential cardiac
dysfunction by assessing left ventricular systolic performance during a dobutamine stress test in patients with early
cirrhosis.
Patients and methods: Nineteen patients with Child A and B cirrhosis (9 with non-alcoholic cirrhosis) and 7 matched
controls were included. We used cardiac magnetic resonance imaging to assess left ventricular volumes and cardiac output
(CO) at rest and during maximal heart rate induced by increasing dosages of dobutamine and atropine.
Results: Patients with cirrhosis and controls had an equal stress response, the heart rate and ejection fraction increased
similarly and maximal heart rate was reached in all. At rest CO was higher in Child B patients than controls. During maximal
stress, Child B patients had higher CO (10.662.7 vs. 8.061.8 L/min), left ventricle end diastolic volume (90625 vs.
67616 mL), left ventricular end diastolic volume (1064 vs. 662 mL) and stroke volume (80623 vs. 61615 mL) than Child A
patients. The systemic vascular resistance was lower in Child B than Child A patients (6706279 vs. 9116274 dyne*s*cm25).
The left ventricle mass increased by 5.6 gram per model for end stage liver disease (MELD) point. MELD score correlated
with the end diastolic and systolic volume, CO, and stroke volume at rest and at stress (all p,0.05).
Conclusion: In patients with early cirrhosis the chronotropoic and inotropic response to pharmacological stress induced by
dobutamine is
OriginalsprogEngelsk
TidsskriftP L o S One
Vol/bind9
Udgave nummer10
Sider (fra-til)e109179
ISSN1932-6203
DOI
StatusUdgivet - 2014

ID: 44631000