Assessment of pulmonary arterial stiffness in patients with cirrhosis: A prospective cohort study

Echocardiography. 2021 Jan;38(1):57-63. doi: 10.1111/echo.14935. Epub 2020 Nov 23.

Abstract

Introduction: In the current literature, several studies show that PAS (pulmonary artery stiffness) is associated with RV (right ventricular) dysfunction, PAH (pulmonary arterial hypertension), and disease severity in subjects with structural cardiac disease, HIV (human immunodeficiency virus), and chronic lung disease. Hence, our main aim was to use PAS to show the early changes in the pulmonary vascular region in subjects with cirrhosis.

Material and methods: In this prospective cross-sectional study, 39 subjects who were being followed up with cirrhosis and 41 age- and sex-matched healthy subjects were included in this study. For each case, the PAS value was obtained by dividing mean peak velocity of the pulmonary flow by the PfAT (pulmonary flow acceleration time).

Results: The measured PAS was 23.62 ± 5.87 (Hz/msn) in cirrhotic participants and 19.09 ± 4.16 (Hz/msn) in healthy cases (P < .001). We found a positive statistical significance between PAS and RVSP (right ventricle systolic pressure)/sPAP (systolic pulmonary arterial pressure) (r = .395; P = .013). PAS was an independent predictor that was associated with cirrhosis disease according to multivariate LR (logistic regression) analysis (OR: 1.209; 95% CI: 1.059-1.381; P = .005).

Conclusion: Based on the study results, we consider that PAS may help in the early detection of findings in the pulmonary vascular area, even if the RV function findings or sPAP is within the normal range.

Keywords: cirrhosis; early; pulmonary arterial hypertension; pulmonary artery stiffness.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Prospective Studies
  • Pulmonary Artery / diagnostic imaging
  • Vascular Stiffness*
  • Ventricular Dysfunction, Right*
  • Ventricular Function, Right