Hepatic sequelae of congestive cardiac failure. Evidence for a liver lesion in patients in whom cardiac function has been restored to normal.
In order to test the hypothesis that clinical and biochemical features of liver disease due to cardiac failure regress upon relief of cardiac decompensation, 38 patients with constrictive pericarditis were studied before and after pericardiectomy for periods ranging from 1 week to 25 years. All patients were judged to be free of clinical evidence of heart failure. Hepatomegaly was present in 10 of the 38 patients studied. Of the patients studied 1-25 years after operation, 96% had elevated serum levels of total and conjugated bilirubin. The percentage Bromsulphalein (BSP) retention at 45 minutes was abnormal in all 29 patients studied 1 year or more after surgery. There was no significant correlation between the level of bilirubin or the percentage BSP retained when these were compared with the pre-operative height of jugular venous pressure, degree of pulsus paradoxus, duration of symptoms or degree of hepatic congestion. Our study reveals that the liver lesion of cardiac failure persists for up to 25 years after restoration of normal cardiac function.
D000293:Adolescent; D000328:Adult; D001663:Bilirubin / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010494:Pericarditis, Constrictive / Q000601:surgery; D011184:Postoperative Period; D013448:Sulfobromophthalein; D013997:Time Factors
D013448:Sulfobromophthalein; D001663:Bilirubin