title: Prevalence and impact on survival of hepatopulmonary syndrome and cirrhotic cardiomyopathy in a cohort of cirrhotic patients.
abstract: OBJECTIVE
  Extrahepatic complications of cirrhosis increase the risk for decompensation of the liver disease and death. Previous studies show common pathogenetic mechanisms involved in the development of hepatopulmonary syndrome and cirrhotic cardiomyopathy. We aimed to assess the link between these entities and their effect on disease-related patient morbidity and mortality.
  
  
  METHODS
  Seventy-four consecutive cirrhotic patients without prior history of cardiovascular and pulmonary disease were included in a prospective observational study. Routine blood work, arterial blood gas analysis, pulse oximetry measurements, N-terminal pro-brain natriuretic peptide levels and contrast enhanced echocardiography examination with tissue Doppler imaging were performed in all patients. Patients were followed up for a median of 6 months and disease-related adverse events and death were the main outcomes tested. Statistical analysis was conducted according to the presence of hepatopulmonary syndrome or cirrhotic cardiomyopathy.
  
  
  RESULTS
  Hepatopulmonary syndrome was diagnosed in 17 patients (23%) and cirrhotic cardiomyopathy in 30 patients (40.5%). There was no association between the presence of cirrhotic cardiomyopathy and the existence of mild or moderate hepatopulmonary syndrome. No echocardiographic parameters were useful in predicting the presence of hepatopulmonary syndrome. N-terminal pro-brain natriuretic peptide levels and length of QT interval did not aid in diagnosis of cirrhotic cardiomyopathy. Neither entity had significant influence on disease-related outcomes in the follow-up period.
  
  
  CONCLUSIONS
  Hepatopulmonary syndrome and cirrhotic cardiomyopathy are independent complications arising in cirrhosis and have a limited influence on morbidity and mortality on a pre-liver transplantation population.
authors.affiliation: Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania.|"Carol Davila" University of Medicine, Bucharest, Romania.
authors.forename: Andrei M
authors.identifier: http://orcid.org/0000-0001-8579-9314
authors.initials: AM
authors.lastname: Voiosu
authors.affiliation: "Carol Davila" University of Medicine, Bucharest, Romania.|Department of Cardiology, Colentina Clinical Hospital, Bucharest, Romania.
authors.forename: Ioana C
authors.initials: IC
authors.lastname: Daha
authors.affiliation: Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania.|"Carol Davila" University of Medicine, Bucharest, Romania.
authors.forename: Theodor A
authors.initials: TA
authors.lastname: Voiosu
authors.affiliation: Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania.|"Carol Davila" University of Medicine, Bucharest, Romania.
authors.forename: Bogdan R
authors.initials: BR
authors.lastname: Mateescu
authors.affiliation: "Carol Davila" University of Medicine, Bucharest, Romania.|Department of Cardiology, Colentina Clinical Hospital, Bucharest, Romania.
authors.forename: Gheorghe A
authors.initials: GA
authors.lastname: Dan
authors.affiliation: "Carol Davila" University of Medicine, Bucharest, Romania.|Department of Internal Medicine, Colentina Clinical Hospital, Bucharest, Romania.
authors.forename: Cristian R
authors.initials: CR
authors.lastname: Băicuş
authors.affiliation: Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania.|"Carol Davila" University of Medicine, Bucharest, Romania.
authors.forename: Mihail R
authors.initials: MR
authors.lastname: Voiosu
authors.affiliation: "Carol Davila" University of Medicine, Bucharest, Romania.|Department of Gastroenterology and Hepatology, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Mircea M
authors.initials: MM
authors.lastname: Diculescu
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012383:Romania / Q000453:epidemiology; D013223:Statistics as Topic; D016019:Survival Analysis
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: cirrhosis; cirrhotic cardiomyopathy; echocardiography; follow-up studies; hepatopulmonary syndrome