RT Journal Article
SR Electronic
T1 To study pulmonary hemodynamics and the prevalence of porto pulmonary hypertension (POPH) in cirrhotic patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1511
VO 40
IS Suppl 56
A1 Sachin Kumar
A1 Praveen Kumar Sharma
A1 Manoj Kumar Sharma
A1 Ashish Kumar
A1 Shiv Kumar Sarin
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1511.abstract
AB BACKGROUND:Pulmonary hypertension (PH) (mean pulmonary artery (MPA) pressure ≥ 25mm Hg at rest) associated with cirrhosis have variable etiologies and prognostic implications.AIM:To study pulmonary hemodynamics and determine the prevalence of porto pulmonary hypertension (POPH) in cirrhotic patients.METHOD:Retrospective study comprised 1492 patients with cirrhosis seen at a tertiary teaching hospital from July 2001 to March 2011 undergoing invasive haemodynamic measurements during hepatic venous pressure gradient (HVPG) study. The data on etiology of cirrhosis, medical history and Child-Pugh classification of liver disease also collected.RESULT:1492 patients(M:F,1177:315, Child A:B:C,378:360:754) mean age 45.4±13.2. 37(2.48%) had confirmed PH and 7 (0.47%) patients satisfied the criteria of POPH. Out of 37 PH patients, precapillary PH was present in 7 (POPH group) while postcapillary PH was present in 30 (2.0%) and was passive in 27 patients. Cardiac dysfunction (n=17), spirometric evidence of COPD (n=10 including 4 overlap with cardiac disease), unknown (n=4) and serological evidence of connective tissue disorders (n=3) were also present in postcapillary PH patients. Only 3 out of 30 patients had reactive postcapillary PH (Transpulmonary gradient (TPG) >12mm Hg). Higher MPA and TPG significantly associated with POPHCONCLUSION:The prevalence of POPH in cirrhosis was 0.47 %. Presence of PH in cirrhotic should alert the physician to search for more common causes other than POPH, may be more amenable to treatment, making them eligible and also reducing the risk associated with untreated PH, especially in patients being considered for liver transplantation.