Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Myocardial extracellular volume quantified by magnetic resonance is increased in cirrhosis and related to poor outcome

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{5d2c24ec8e3245408823beee886c3c47,
title = "Myocardial extracellular volume quantified by magnetic resonance is increased in cirrhosis and related to poor outcome",
abstract = "BACKGROUND & AIMS: The underlying pathogenesis of cirrhotic cardiomyopathy is unclear. Structural myocardial changes including diffuse fibrosis may be involved and can be accurately assessed by cardiac MRI (CMR) with quantification of the extracellular volume (ECV).This is the first application of this technique in patients with cirrhosis. We aimed to investigate the presence of diffuse myocardial fibrosis and to determine the relation to disease severity, cardiac function, and outcome.METHODS: A prospective study including 52 cirrhotic patients and 10 healthy controls. All patients underwent CMR with ECV quantification, tissue Doppler echocardiography, and biochemical assessments. Patients were follow-up for a median of 25 months with registration of death and liver transplantation (LT).RESULTS: Myocardial ECV was higher in the patients compared with healthy controls (31.2±6 vs. 27.4±3{\%}, P=0.04). Furthermore, ECV increased across the Child Pugh A/B/C classes (26.9±4/ 31.5±5/ 34.4±6{\%}, P=0.02). Four-teen patients experienced the composite end-point of death/LT during follow-up and these patients had higher ECV (33.2±4 vs. 30.4±6{\%}, P=0.04). In a univariate Cox regression analysis ECV was associated with poor transplant-free survival (HR 3.6 [1.1-11.6]; P=0.03). However, MELD and CRP remained the strongest predictors in a multivariate analysis. ECV correlated with cardiac index (r=0.44, P=0.001), CRP (r=0.46, P=0.001), proANP (r=0.50, P<0.001), and proBNP (r=0.40, P=0.005).CONCLUSIONS: Myocardial ECV is increased in patients with cirrhosis and seems related to disease severity and transplant-free survival. These changes most likely reflect subclinical diffuse myocardial fibrosis and may represent a structural element of cirrhotic cardiomyopathy. This article is protected by copyright. All rights reserved.",
keywords = "Journal Article",
author = "Signe Wiese and Jens Hove and Silje Mo and Mookerjee, {Rajeshwar P} and Petersen, {Claus L} and Vester-Andersen, {Marianne K} and Mygind, {Naja D} and Goetze, {Jens P} and Andreas Kjaer and Flemming Bendtsen and S{\o}ren M{\o}ller",
note = "This article is protected by copyright. All rights reserved.",
year = "2018",
doi = "10.1111/liv.13870",
language = "English",
volume = "38",
pages = "1614--1623",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell Munksgaard",
number = "9",

}

RIS

TY - JOUR

T1 - Myocardial extracellular volume quantified by magnetic resonance is increased in cirrhosis and related to poor outcome

AU - Wiese, Signe

AU - Hove, Jens

AU - Mo, Silje

AU - Mookerjee, Rajeshwar P

AU - Petersen, Claus L

AU - Vester-Andersen, Marianne K

AU - Mygind, Naja D

AU - Goetze, Jens P

AU - Kjaer, Andreas

AU - Bendtsen, Flemming

AU - Møller, Søren

N1 - This article is protected by copyright. All rights reserved.

PY - 2018

Y1 - 2018

N2 - BACKGROUND & AIMS: The underlying pathogenesis of cirrhotic cardiomyopathy is unclear. Structural myocardial changes including diffuse fibrosis may be involved and can be accurately assessed by cardiac MRI (CMR) with quantification of the extracellular volume (ECV).This is the first application of this technique in patients with cirrhosis. We aimed to investigate the presence of diffuse myocardial fibrosis and to determine the relation to disease severity, cardiac function, and outcome.METHODS: A prospective study including 52 cirrhotic patients and 10 healthy controls. All patients underwent CMR with ECV quantification, tissue Doppler echocardiography, and biochemical assessments. Patients were follow-up for a median of 25 months with registration of death and liver transplantation (LT).RESULTS: Myocardial ECV was higher in the patients compared with healthy controls (31.2±6 vs. 27.4±3%, P=0.04). Furthermore, ECV increased across the Child Pugh A/B/C classes (26.9±4/ 31.5±5/ 34.4±6%, P=0.02). Four-teen patients experienced the composite end-point of death/LT during follow-up and these patients had higher ECV (33.2±4 vs. 30.4±6%, P=0.04). In a univariate Cox regression analysis ECV was associated with poor transplant-free survival (HR 3.6 [1.1-11.6]; P=0.03). However, MELD and CRP remained the strongest predictors in a multivariate analysis. ECV correlated with cardiac index (r=0.44, P=0.001), CRP (r=0.46, P=0.001), proANP (r=0.50, P<0.001), and proBNP (r=0.40, P=0.005).CONCLUSIONS: Myocardial ECV is increased in patients with cirrhosis and seems related to disease severity and transplant-free survival. These changes most likely reflect subclinical diffuse myocardial fibrosis and may represent a structural element of cirrhotic cardiomyopathy. This article is protected by copyright. All rights reserved.

AB - BACKGROUND & AIMS: The underlying pathogenesis of cirrhotic cardiomyopathy is unclear. Structural myocardial changes including diffuse fibrosis may be involved and can be accurately assessed by cardiac MRI (CMR) with quantification of the extracellular volume (ECV).This is the first application of this technique in patients with cirrhosis. We aimed to investigate the presence of diffuse myocardial fibrosis and to determine the relation to disease severity, cardiac function, and outcome.METHODS: A prospective study including 52 cirrhotic patients and 10 healthy controls. All patients underwent CMR with ECV quantification, tissue Doppler echocardiography, and biochemical assessments. Patients were follow-up for a median of 25 months with registration of death and liver transplantation (LT).RESULTS: Myocardial ECV was higher in the patients compared with healthy controls (31.2±6 vs. 27.4±3%, P=0.04). Furthermore, ECV increased across the Child Pugh A/B/C classes (26.9±4/ 31.5±5/ 34.4±6%, P=0.02). Four-teen patients experienced the composite end-point of death/LT during follow-up and these patients had higher ECV (33.2±4 vs. 30.4±6%, P=0.04). In a univariate Cox regression analysis ECV was associated with poor transplant-free survival (HR 3.6 [1.1-11.6]; P=0.03). However, MELD and CRP remained the strongest predictors in a multivariate analysis. ECV correlated with cardiac index (r=0.44, P=0.001), CRP (r=0.46, P=0.001), proANP (r=0.50, P<0.001), and proBNP (r=0.40, P=0.005).CONCLUSIONS: Myocardial ECV is increased in patients with cirrhosis and seems related to disease severity and transplant-free survival. These changes most likely reflect subclinical diffuse myocardial fibrosis and may represent a structural element of cirrhotic cardiomyopathy. This article is protected by copyright. All rights reserved.

KW - Journal Article

U2 - 10.1111/liv.13870

DO - 10.1111/liv.13870

M3 - Journal article

VL - 38

SP - 1614

EP - 1623

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 9

ER -

ID: 53714959