Predictors of cardiac hepatopathy in patients with right heart failure

Sherry Megalla, Dvorah Holtzman, Wilbert S. Aronow, Reza Nazari, Svetlana Korenfeld, Aron Schwarcz, Ythan Goldberg, Daniel M. Spevack

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Some patients with right heart failure develop cardiac hepatopathy (CH). The pathophysiology of CH is thought to be secondary to hepatic venous congestion and arterial ischemia. We sought to defne the clinical and hemodynamic characteristics associated with CH. Material/Methods: A retrospective cross sectional analysis was performed in which subjects were identifed from our institutional cardiology database if echocardiography showed either right ventricular (RV) hypo-kinesis or dilatation, and was performed within 30 days of right heart catheterization. A chart review was then performed to identify patient clinical characteristics and to determine if the patients had underlying liver disease. Subjects with non-cardiac causes for hepatopathy were excluded. Results: In 188 included subjects, etiology for right heart dysfunction included left heart failure (LHF), shunt, pulmonary hypertension, mitral- tricuspid- and pulmonic valvular disease. On multivariate analysis, higher RV diastolic pressure and etiology for RV dysfunction other than LHF were both associated with CH. Low cardiac output was associated with CH only amongst those without LHF. Conclusions: CH is most often seen in subjects with elevated RV diastolic pressure suggesting a congestive cause in most cases. CH associated with low cardiac output in patients without LHF suggests that low fow may be contributing to the patophysiology in some cases.

Original languageEnglish (US)
JournalMedical Science Monitor
Volume17
Issue number10
StatePublished - 2011

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Patient Rights
Heart Failure
Low Cardiac Output
Ventricular Pressure
Kinesis
Blood Pressure
Right Ventricular Dysfunction
Hyperemia
Cardiac Catheterization
Cardiology
Pulmonary Hypertension
Lung Diseases
Echocardiography
Liver Diseases
Dilatation
Multivariate Analysis
Ischemia
Cross-Sectional Studies
Hemodynamics
Databases

Keywords

  • Cardiac hepatopathy
  • Congestive heart failure
  • Right heart failure

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Megalla, S., Holtzman, D., Aronow, W. S., Nazari, R., Korenfeld, S., Schwarcz, A., ... Spevack, D. M. (2011). Predictors of cardiac hepatopathy in patients with right heart failure. Medical Science Monitor, 17(10).

Predictors of cardiac hepatopathy in patients with right heart failure. / Megalla, Sherry; Holtzman, Dvorah; Aronow, Wilbert S.; Nazari, Reza; Korenfeld, Svetlana; Schwarcz, Aron; Goldberg, Ythan; Spevack, Daniel M.

In: Medical Science Monitor, Vol. 17, No. 10, 2011.

Research output: Contribution to journalArticle

Megalla, S, Holtzman, D, Aronow, WS, Nazari, R, Korenfeld, S, Schwarcz, A, Goldberg, Y & Spevack, DM 2011, 'Predictors of cardiac hepatopathy in patients with right heart failure', Medical Science Monitor, vol. 17, no. 10.
Megalla S, Holtzman D, Aronow WS, Nazari R, Korenfeld S, Schwarcz A et al. Predictors of cardiac hepatopathy in patients with right heart failure. Medical Science Monitor. 2011;17(10).
Megalla, Sherry ; Holtzman, Dvorah ; Aronow, Wilbert S. ; Nazari, Reza ; Korenfeld, Svetlana ; Schwarcz, Aron ; Goldberg, Ythan ; Spevack, Daniel M. / Predictors of cardiac hepatopathy in patients with right heart failure. In: Medical Science Monitor. 2011 ; Vol. 17, No. 10.
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AB - Background: Some patients with right heart failure develop cardiac hepatopathy (CH). The pathophysiology of CH is thought to be secondary to hepatic venous congestion and arterial ischemia. We sought to defne the clinical and hemodynamic characteristics associated with CH. Material/Methods: A retrospective cross sectional analysis was performed in which subjects were identifed from our institutional cardiology database if echocardiography showed either right ventricular (RV) hypo-kinesis or dilatation, and was performed within 30 days of right heart catheterization. A chart review was then performed to identify patient clinical characteristics and to determine if the patients had underlying liver disease. Subjects with non-cardiac causes for hepatopathy were excluded. Results: In 188 included subjects, etiology for right heart dysfunction included left heart failure (LHF), shunt, pulmonary hypertension, mitral- tricuspid- and pulmonic valvular disease. On multivariate analysis, higher RV diastolic pressure and etiology for RV dysfunction other than LHF were both associated with CH. Low cardiac output was associated with CH only amongst those without LHF. Conclusions: CH is most often seen in subjects with elevated RV diastolic pressure suggesting a congestive cause in most cases. CH associated with low cardiac output in patients without LHF suggests that low fow may be contributing to the patophysiology in some cases.

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