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Cardiodynamic state is associated with systemic inflammation and fatal acute-on-chronic liver failure

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Praktiknjo, Michael ; Monteiro, Sofia ; Grandt, Josephine ; Kimer, Nina ; Madsen, Jan Lysgård ; Werge, Mikkel P ; William, Peter ; Brol, Maximilian ; Turco, Laura ; Schierwagen, Robert ; Chang, Johannes ; Klein, Sabine ; Uschner, Frank Erhard ; Welsch, Christoph ; Moreau, Richard ; Schepis, Filippo ; Bendtsen, Flemming ; Gluud, Lise Lotte ; Møller, Søren ; Trebicka, Jonel. / Cardiodynamic state is associated with systemic inflammation and fatal acute-on-chronic liver failure. In: Liver international : official journal of the International Association for the Study of the Liver. 2020 ; Vol. 40, No. 6. pp. 1457-1466.

Bibtex

@article{66ac5f6783284ae691382982a84b37c4,
title = "Cardiodynamic state is associated with systemic inflammation and fatal acute-on-chronic liver failure",
abstract = "Background & Aims: Acute-on-chronic liver failure (ACLF) is characterized by high short-term mortality and systemic inflammation (SI). Recently, different cardiodynamic states were shown to independently predict outcomes in cirrhosis. The relationship between cardiodynamic states, SI, and portal hypertension and their impact on ACLF development remains unclear. The aim of this study was therefore to evaluate the interplay of cardiodynamic state and SI on fatal ACLF development in cirrhosis. Results: At inclusion, hemodynamic measures including cardiac index (CI) and hepatic venous pressure gradient of 208 patients were measured. Patients were followed prospectively for fatal ACLF development (primary endpoint). SI was assessed by proinflammatory markers such as interleukins (ILs) 6 and 8 and soluble IL-33 receptor (sIL-33R). Patients were divided according to CI (<3.2; 3.2-4.2; >4.2 L/min/m 2) in hypo- (n = 84), normo- (n = 69) and hyperdynamic group (n = 55). After a median follow-up of 3 years, the highest risk of fatal ACLF was seen in hyperdynamic (35{\%}) and hypodynamic patients (25{\%}) compared with normodynamic (14{\%}) (P =.011). Hyperdynamic patients showed the highest rate of SI. The detectable level of IL-6 was an independent predictor of fatal ACLF development. Conclusions: Cirrhotic patients with hyperdynamic and hypodynamic circulation have a higher risk of fatal ACLF. Therefore, the cardiodynamic state is strongly associated with SI, which is an independent predictor of development of fatal ACLF.",
keywords = "acute-on-chronic liver failure, circulation, cirrhosis, hemodynamic, inflammation",
author = "Michael Praktiknjo and Sofia Monteiro and Josephine Grandt and Nina Kimer and Madsen, {Jan Lysg{\aa}rd} and Werge, {Mikkel P} and Peter William and Maximilian Brol and Laura Turco and Robert Schierwagen and Johannes Chang and Sabine Klein and Uschner, {Frank Erhard} and Christoph Welsch and Richard Moreau and Filippo Schepis and Flemming Bendtsen and Gluud, {Lise Lotte} and S{\o}ren M{\o}ller and Jonel Trebicka",
note = "{\circledC} 2020 The Authors. Liver International published by John Wiley & Sons Ltd.",
year = "2020",
month = "6",
doi = "10.1111/liv.14433",
language = "English",
volume = "40",
pages = "1457--1466",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell Munksgaard",
number = "6",

}

RIS

TY - JOUR

T1 - Cardiodynamic state is associated with systemic inflammation and fatal acute-on-chronic liver failure

AU - Praktiknjo, Michael

AU - Monteiro, Sofia

AU - Grandt, Josephine

AU - Kimer, Nina

AU - Madsen, Jan Lysgård

AU - Werge, Mikkel P

AU - William, Peter

AU - Brol, Maximilian

AU - Turco, Laura

AU - Schierwagen, Robert

AU - Chang, Johannes

AU - Klein, Sabine

AU - Uschner, Frank Erhard

AU - Welsch, Christoph

AU - Moreau, Richard

AU - Schepis, Filippo

AU - Bendtsen, Flemming

AU - Gluud, Lise Lotte

AU - Møller, Søren

AU - Trebicka, Jonel

N1 - © 2020 The Authors. Liver International published by John Wiley & Sons Ltd.

PY - 2020/6

Y1 - 2020/6

N2 - Background & Aims: Acute-on-chronic liver failure (ACLF) is characterized by high short-term mortality and systemic inflammation (SI). Recently, different cardiodynamic states were shown to independently predict outcomes in cirrhosis. The relationship between cardiodynamic states, SI, and portal hypertension and their impact on ACLF development remains unclear. The aim of this study was therefore to evaluate the interplay of cardiodynamic state and SI on fatal ACLF development in cirrhosis. Results: At inclusion, hemodynamic measures including cardiac index (CI) and hepatic venous pressure gradient of 208 patients were measured. Patients were followed prospectively for fatal ACLF development (primary endpoint). SI was assessed by proinflammatory markers such as interleukins (ILs) 6 and 8 and soluble IL-33 receptor (sIL-33R). Patients were divided according to CI (<3.2; 3.2-4.2; >4.2 L/min/m 2) in hypo- (n = 84), normo- (n = 69) and hyperdynamic group (n = 55). After a median follow-up of 3 years, the highest risk of fatal ACLF was seen in hyperdynamic (35%) and hypodynamic patients (25%) compared with normodynamic (14%) (P =.011). Hyperdynamic patients showed the highest rate of SI. The detectable level of IL-6 was an independent predictor of fatal ACLF development. Conclusions: Cirrhotic patients with hyperdynamic and hypodynamic circulation have a higher risk of fatal ACLF. Therefore, the cardiodynamic state is strongly associated with SI, which is an independent predictor of development of fatal ACLF.

AB - Background & Aims: Acute-on-chronic liver failure (ACLF) is characterized by high short-term mortality and systemic inflammation (SI). Recently, different cardiodynamic states were shown to independently predict outcomes in cirrhosis. The relationship between cardiodynamic states, SI, and portal hypertension and their impact on ACLF development remains unclear. The aim of this study was therefore to evaluate the interplay of cardiodynamic state and SI on fatal ACLF development in cirrhosis. Results: At inclusion, hemodynamic measures including cardiac index (CI) and hepatic venous pressure gradient of 208 patients were measured. Patients were followed prospectively for fatal ACLF development (primary endpoint). SI was assessed by proinflammatory markers such as interleukins (ILs) 6 and 8 and soluble IL-33 receptor (sIL-33R). Patients were divided according to CI (<3.2; 3.2-4.2; >4.2 L/min/m 2) in hypo- (n = 84), normo- (n = 69) and hyperdynamic group (n = 55). After a median follow-up of 3 years, the highest risk of fatal ACLF was seen in hyperdynamic (35%) and hypodynamic patients (25%) compared with normodynamic (14%) (P =.011). Hyperdynamic patients showed the highest rate of SI. The detectable level of IL-6 was an independent predictor of fatal ACLF development. Conclusions: Cirrhotic patients with hyperdynamic and hypodynamic circulation have a higher risk of fatal ACLF. Therefore, the cardiodynamic state is strongly associated with SI, which is an independent predictor of development of fatal ACLF.

KW - acute-on-chronic liver failure

KW - circulation

KW - cirrhosis

KW - hemodynamic

KW - inflammation

UR - http://www.scopus.com/inward/record.url?scp=85082529126&partnerID=8YFLogxK

U2 - 10.1111/liv.14433

DO - 10.1111/liv.14433

M3 - Journal article

VL - 40

SP - 1457

EP - 1466

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 6

ER -

ID: 59545471