Prevalence of intrapulmonary vascular dilatations in normoxaemic patients with early liver cirrhosis.
BACKGROUND
The aim of this study was to determine the prevalence of intrapulmonary vascular dilatations (IPVD) in normoxaemic patients with early liver cirrhosis and to compare their occurrence in progressive alcoholic versus postviral hepatic insufficiency.


METHODS
Pulmonary function tests and arterial blood gas measurements were performed in 75 consecutive patients with cirrhosis of alcoholic and postviral aetiology. Contrast-enhanced echocardiography was used to identify IPVD.


RESULTS
All patients were grade A or B in accordance with the Child-Pugh modified classification. Arterial blood gas analyses showed normoxaemia in all patients. Eight of 75 patients (10.7%) had a positive contrast echocardiogram, all with a decreased diffusion capacity (D1CO < 75% of the expected value). The abnormality was more prominent with advancing stage of liver failure (4.5% in grade A versus 19.4% in grade B; P < 0.05) and more common in patients with alcoholic cirrhosis (17.5% in alcoholic versus 2.9% in postviral cirrhosis; P < 0.05).


CONCLUSIONS
In normoxaemic patients with early liver cirrhosis subclinical pulmonary vasodilatation, as assessed with contrast echocardiography, can occur. The finding is more prominent in alcoholic cirrhosis and possibly reflects an advancing degree of liver insufficiency.
Dept. of Internal Medicine, University Hospital, Patras, Greece.
K P
KP
Mimidis
C
C
Karatza
K V
KV
Spiropoulos
T
T
Toulgaridis
N A
NA
Charokopos
K C
KC
Thomopoulos
V G
VG
Margaritis
V N
VN
Nikolopoulou
D004452:Echocardiography; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications; D020065:Hepatopulmonary Syndrome / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000503:physiopathology*; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology*; D017093:Liver Failure / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D015995:Prevalence; D011652:Pulmonary Circulation; D012129:Respiratory Function Tests; D014664:Vasodilation
D010100:Oxygen