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Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis
BACKGROUND/AIMS: The blunted ventricular systolic and diastolic contractile responses to physical and pharmacological stress in cirrhosis are termed cirrhotic cardiomyopathy (CCM). CCM has been known to involve multiple defects in the β-adrenergic signaling pathway. The aim of this study was to dete...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Association for the Study of the Liver
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304603/ https://www.ncbi.nlm.nih.gov/pubmed/21415581 http://dx.doi.org/10.3350/kjhep.2010.16.4.376 |
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author | Kim, Moon Young Baik, Soon Koo Won, Chan Sik Park, Hong Jun Jeon, Hyo Keun Hong, Hyun Il Kim, Jae Woo Kim, Hyun Soo Kwon, Sang Ok Kim, Jang Young Yoo, Byung Su Lee, Seung Hwan |
author_facet | Kim, Moon Young Baik, Soon Koo Won, Chan Sik Park, Hong Jun Jeon, Hyo Keun Hong, Hyun Il Kim, Jae Woo Kim, Hyun Soo Kwon, Sang Ok Kim, Jang Young Yoo, Byung Su Lee, Seung Hwan |
author_sort | Kim, Moon Young |
collection | PubMed |
description | BACKGROUND/AIMS: The blunted ventricular systolic and diastolic contractile responses to physical and pharmacological stress in cirrhosis are termed cirrhotic cardiomyopathy (CCM). CCM has been known to involve multiple defects in the β-adrenergic signaling pathway. The aim of this study was to determine whether cirrhotic patients have blunted cardiac responses to catecholamine stimulation through dobutamine stress echocardiography (DSE). METHODS: Seventy-one cirrhotic patients with normal left ventricular (LV) chamber size and ejection fraction were enrolled. The LV systolic and diastolic functions were evaluated by two-dimensional and Doppler echocardiography at rest and during peak dobutamine infusion (40 µg/kg/min). An abnormal response was defined as a decrease of less than 10% in LV end-diastolic volume, a decrease of less than 20% in end-systolic volume, and an increase of less than 10% in LV ejection fraction (EF) at peak dobutamine infusion, based on previously used criteria. The early/late diastolic flow (E/A) ratio and diastolic parameters were also measured. RESULTS: A blunted LV response to dobutamine was observed in 18 of 71 cirrhotic patients (25.4%). The baseline EF was significantly higher in 18 patients with a blunted DSE response than that of those with a normal DSE response (P<0.05). The baseline and peak E/A ratios, which are common diastolic dysfunction markers, were higher in the cirrhosis group than in the control group (P<0.001). No adverse events associated with DSE were observed. CONCLUSIONS: Blunted cardiac responses to dobutamine stimulation, which are implicated in defects in the β-adrenergic signaling pathway, might contribute to the pathogenesis of CCM in patients with cirrhosis. |
format | Online Article Text |
id | pubmed-3304603 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | The Korean Association for the Study of the Liver |
record_format | MEDLINE/PubMed |
spelling | pubmed-33046032012-03-20 Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis Kim, Moon Young Baik, Soon Koo Won, Chan Sik Park, Hong Jun Jeon, Hyo Keun Hong, Hyun Il Kim, Jae Woo Kim, Hyun Soo Kwon, Sang Ok Kim, Jang Young Yoo, Byung Su Lee, Seung Hwan Korean J Hepatol Original Article BACKGROUND/AIMS: The blunted ventricular systolic and diastolic contractile responses to physical and pharmacological stress in cirrhosis are termed cirrhotic cardiomyopathy (CCM). CCM has been known to involve multiple defects in the β-adrenergic signaling pathway. The aim of this study was to determine whether cirrhotic patients have blunted cardiac responses to catecholamine stimulation through dobutamine stress echocardiography (DSE). METHODS: Seventy-one cirrhotic patients with normal left ventricular (LV) chamber size and ejection fraction were enrolled. The LV systolic and diastolic functions were evaluated by two-dimensional and Doppler echocardiography at rest and during peak dobutamine infusion (40 µg/kg/min). An abnormal response was defined as a decrease of less than 10% in LV end-diastolic volume, a decrease of less than 20% in end-systolic volume, and an increase of less than 10% in LV ejection fraction (EF) at peak dobutamine infusion, based on previously used criteria. The early/late diastolic flow (E/A) ratio and diastolic parameters were also measured. RESULTS: A blunted LV response to dobutamine was observed in 18 of 71 cirrhotic patients (25.4%). The baseline EF was significantly higher in 18 patients with a blunted DSE response than that of those with a normal DSE response (P<0.05). The baseline and peak E/A ratios, which are common diastolic dysfunction markers, were higher in the cirrhosis group than in the control group (P<0.001). No adverse events associated with DSE were observed. CONCLUSIONS: Blunted cardiac responses to dobutamine stimulation, which are implicated in defects in the β-adrenergic signaling pathway, might contribute to the pathogenesis of CCM in patients with cirrhosis. The Korean Association for the Study of the Liver 2010-12 2010-12-31 /pmc/articles/PMC3304603/ /pubmed/21415581 http://dx.doi.org/10.3350/kjhep.2010.16.4.376 Text en Copyright © 2010 by The Korean Association for the Study of the Liver http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Moon Young Baik, Soon Koo Won, Chan Sik Park, Hong Jun Jeon, Hyo Keun Hong, Hyun Il Kim, Jae Woo Kim, Hyun Soo Kwon, Sang Ok Kim, Jang Young Yoo, Byung Su Lee, Seung Hwan Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
title | Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
title_full | Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
title_fullStr | Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
title_full_unstemmed | Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
title_short | Dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
title_sort | dobutamine stress echocardiography for evaluating cirrhotic cardiomyopathy in liver cirrhosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304603/ https://www.ncbi.nlm.nih.gov/pubmed/21415581 http://dx.doi.org/10.3350/kjhep.2010.16.4.376 |
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