Key result
In patients with liver cirrhosis, left atrial volume was significantly greater in those with hepatopulmonary syndrome compared to matched controls (55.1 vs 37.1 mL, P<0.05).
Why the study?
Does left atrial volume predict the presence of hepatopulmonary syndrome in adult patients with liver cirrhosis?
Case-Control (n=149)
Does left atrial volume predict the presence of hepatopulmonary syndrome in adult patients with liver cirrhosis?
Absolute Event Rate: 55.1% vs 37.1%
p-value: p=<0.05
Left atrial volume ≥ 50 mL is a highly sensitive and specific echocardiographic marker for detecting hepatopulmonary syndrome in patients with liver cirrhosis.
May support LA volume screening for HPS in cirrhosis transplant candidates; leaves open validation in outcome studies.
OBJECTIVES: We studied patients with hepato-pulmonary syndrome (HPS). We found that HPS is frequently present in patients with left atrial enlargement. The aim of this prospective study was to evaluate the possible correlation between left atrial volume and HPS. METHODS: Adult patients (>18 yr old) with biopsy proven liver cirrhosis who were referred for liver transplantation were enrolled in the study. Diagnosis of HPS was established when the following points were fulfilled: (a) the presence of chronic liver disease, (b) increased alveolar-arterial difference (AaDO(2)), (c) intrapulmonary vascular dilatation, and (d) absence of primary cardiac or pulmonary disease. RESULTS: We enrolled 41 patients (mean age 47.1 +/- 10.6 yr) diagnosed with HPS. Also 108 Child-Pugh score matched cirrhotic patients (mean age 49.2 +/- 9.3 yr) who have negative contrast echocardiography and normal age-related AaDO(2) were selected as a control group for the purpose of comparison of left atrial volume (LAV). LAV was significantly greater in patients with HPS compared to the control group (55.1 +/- 7.5 mL vs 37.1 +/- 9.3 mL, P < 0.05). The area under the receiver-operating characteristic (ROC) curve for LAV was 0.903 (Cut point >/= 50 mL, sensitivity 86.3%, specificity 81.2%). CONCLUSION: In the context of liver cirrhosis, LAV >/= 50 mL is a simple and feasible parameter to detect HPS.
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Zamirian et al. (2007) conducted a case-control in Hepatopulmonary Syndrome (n=149). Hepatopulmonary syndrome vs. Matched cirrhotic patients without hepatopulmonary syndrome was evaluated on Left atrial volume (p=<0.05). In patients with liver cirrhosis, left atrial volume was significantly greater in those with hepatopulmonary syndrome compared to matched controls (55.1 vs 37.1 mL, P<0.05).
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