Am J Physiol Gastrointest Liver Physiol 2018 02 26;314(2):G275-G286. Epub 2017 Oct 26.
Department of Clinical Physiology and Nuclear Medicine, Centre of Functional Imaging and Research, Copenhagen University Hospital Hvidovre , Copenhagen , Denmark.
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Dig Liver Dis 2017 Dec 27;49(12):1353-1359. Epub 2017 Jun 27.
Centre of Functional Imaging and Research, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Hvidovre, Denmark.
Background: Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes.
Aims: To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. Read More
Gut 1999 May;44(5):743-8
Department of Gastroenterology, Medical University Hospital, Freiburg, Germany.
Background: A portosystemic stent shunt may impair cardiac function and haemodynamics.
Aims: To investigate the effects of a transjugular intrahepatic portosystemic shunt (TIPS) on cardiac function and pulmonary and systemic circulation in patients with alcoholic cirrhosis.
Patients/methods: 17 patients with alcoholic cirrhosis and recent variceal bleeding were evaluated by echocardiography and catheterisation of the splanchnic and pulmonary circulation before and after TIPS. Read More
Gut 1996 Oct;39(4):600-4
Radiology Department, André-Viallet Clinical Research Center, Hôpital Saint-Luc, University of Montreal, Québec, Canada.
Background And Aims: In portal hypertensive patients, transjugular intrahepatic portosystemic shunt (TIPS) acutely increases cardiac output and exaggerates peripheral vasodilatation. It has been suggested that the worsened hyperdynamic state may progress to high output heart failure. The aim was to evaluate the acute and short-term haemodynamic adaptation to this procedure. Read More
Am J Gastroenterol 2009 Oct 16;104(10):2458-66. Epub 2009 Jun 16.
The Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada.
Objectives: The clinical significance of diastolic dysfunction in cirrhosis, a feature of cirrhotic cardiomyopathy, is unclear. The aim of this study was to assess the utility of E/A ratio, an indicator of diastolic dysfunction, to predict ascites clearance and mortality after transjugular intrahepatic portosystemic stent shunt (TIPS) insertion.
Methods: A total of 101 cirrhotic patients who received TIPS had pre-TIPS assessments of demographics, severity of liver dysfunction (Child-Pugh and Model for End-Stage Liver Disease (MELD) scores), renal function, hemodynamics, and cardiac function (two-dimensional echocardiography). Read More