Publications by authors named "Konstantin Ivashkin"

3 Publications

  • Page 1 of 1

Gut dysbiosis is associated with poorer long-term prognosis in cirrhosis.

World J Hepatol 2021 May;13(5):557-570

Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Moscow 119435, Russia.

Background: Gut dysbiosis is common in cirrhosis.

Aim: To study the influence of gut dysbiosis on prognosis in cirrhosis.

Methods: The case-control study included 48 in-patients with cirrhosis and 21 healthy controls. Stool microbiome was assessed using 16S ribosomal ribonucleic acid gene sequencing. We used modified dysbiosis ratio (MDR): [ (%) + (%)]/[ (%) + (%)]. Patients with MDR more the median made up the group with severe dysbiosis, others did the group with non-severe dysbiosis. The follow-up period was 4 years.

Results: The mortality rate of patients with severe dysbiosis was significantly higher than that of patients with non-severe dysbiosis (54.2% 12.5%; = 0.001). The presence of severe dysbiosis was independent risk factors for death [hazard ratio = 8.6 × (1.9-38.0); = 0.005]. The abundance of ( = 0.002), ( = 0.002), and ( = 0.025) was increased and the abundance of ( = 0.025) and ( = 0.045) was decreased in the deceased patients compared with the survivors. The deceased patients had a higher MDR value than the survivors [0.131 × (0.069-0.234) 0.034 × (0.009-0.096); = 0.004]. If we applied an MDR value of 0.14 as the cutoff point, then it predicted patient death within the next year with a sensitivity of 71.4% and a specificity of 82.9% [area under the curve = 0.767 × (0.559-0.974)]. MDR was higher in patients with cirrhosis than in health controls [0.064 × (0.017-0.131) 0.005 × (0.002-0.007); < 0.001], and in patients with decompensated cirrhosis than in patients with compensated cirrhosis [0.106 × (0.023-0.211) 0.033 × (0.012-0.074); = 0.031]. MDR correlated negatively with prothrombin ( = -0.295; = 0.042), cholinesterase ( = -0.466; = 0.014) and serum albumin ( = -0.449; = 0.001) level and positively with Child-Turcotte-Pugh scale value ( = 0.360; = 0.012).

Conclusion: Gut dysbiosis is associated with a poorer long-term prognosis in cirrhosis.
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http://dx.doi.org/10.4254/wjh.v13.i5.557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173342PMC
May 2021

Clinical validation of the "7 × 7" questionnaire for patients with functional gastrointestinal disorders.

J Gastroenterol Hepatol 2019 Jun 25;34(6):1042-1048. Epub 2018 Dec 25.

V.H. Vasilenko Clinic of Internal Diseases, Propedeutics, Gastroenterology and Hepatology, Sechenov University, Moscow, Russia.

Background And Aim: Physicians use different scales and questionnaires to assess the severity of clinical symptoms in patients with functional gastrointestinal disorders. The current study aimed to validate the "7 × 7" questionnaire for assessment of severity of the symptoms as a tool for the efficacy of treatment of functional gastrointestinal disorders, using the Clinical Global Impressions scale as the reference standard.

Methods: Fifty inpatients aged from 18 to 64 with a confirmed diagnosis of irritable bowel syndrome (26 patients, 52%), functional dyspepsia (15 patients, 30%), or both (9 patients, 18%) were prospectively enrolled in the study. We used both the 7 × 7 questionnaire and the Clinical Global Impressions scale before and after 28 days of stable treatment.

Results: Our study revealed a significant correlation between the 7 × 7 questionnaire and the Clinical Global Impressions scale results in assessment of severity of the clinical symptoms and their dynamics during treatment. The 7 × 7 questionnaire showed sensitivity of 74.5% and specificity of 54.1% for evaluating patients with mild to severe disease and 66.6% and 76%, respectively, for evaluating patients with moderate to severe disease. The Cronbach's alpha coefficient was 0.719. The intraclass correlation coefficient among participants in whom the condition remained the same was 0.973 (12 participants [24.5%]).

Conclusions: The 7 × 7 questionnaire is a convenient, sensitive, and reliable tool for assessing the severity of symptoms and treatment efficacy in people with functional gastrointestinal disorders.
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http://dx.doi.org/10.1111/jgh.14546DOI Listing
June 2019

NT-proBNP as a biomarker for hyperdynamic circulation in decompensated cirrhosis.

Gastroenterol Hepatol Bed Bench 2018 ;11(4):325-332

Sechenov First Moscow State Medical University (Sechenov University), Clinic for Internal Diseases, Gastroenterology and Hepatology Pogodinskaya str., 1, bld. 1, 119435, Moscow , Russian Federation.

Aim: To assess NT-proBNP as a biomarker for hyperdynamic circulation in decompensated cirrhosis.

Background: Hyperdynamic circulation is common in decompensated cirrhosis. The previous studies reveal that N-terminal-proBNP (NT-proBNP) is elevated in cirrhosis.

Methods: A prospective study involved 47 patients with decompensated cirrhosis. All of them underwent echocardiography with simultaneous measurement of blood pressure and heart rate. Cardiac output and systemic vascular resistance were calculated. The concentration of NT-proBNP in blood was measured with enzyme-linked immunosorbent assay.

Results: In patients with decompensated cirrhosis, the concentration of NT-proBNP in blood directly correlated with end-diastolic volume (r=0.482; p<0.001), stroke volume (r= 0.566; p<0.001), cardiac output (r=0.556; p<0.001), volume of the left atrium (r=0.292; p=0.047), and inversely correlated with systemic vascular resistance (r=-0.538; p<0.001). There was no significant correlation between NT-proBNP and ejection fraction (p=0.083). Patients with hyperdynamic circulation have higher concentration of NT-proBNP (152÷476 pg/ml vs. 31÷133 pg/ml, p<0.001) regardless of the presence of diastolic dysfunction (p=0.222). According to ROC analysis, the best cut-off values for detection of hyperdynamic circulation in decompensated cirrhosis are considered to be 170.0 pg/ml of blood NT-proBNP, showing sensitivity and specificity of 72.0 and 86.4%, respectively. The positive and negative predictive value are 86.4% and 73.1%, AUC = 0.829 (0.709-0.949).

Conclusion: NT-proBNP may serve as a non-invasive biomarker for hyperdynamic circulation in decompensated cirrhosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204251PMC
January 2018
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