Preview

Rational Pharmacotherapy in Cardiology

Advanced search

POSSIBLE CHANGES IN THE CENTRAL HEMODYNAMICS IN PORTAL HYPERTENSION DUE TO LIVER CIRRHOSIS OF VIRAL ETIOLOGY WITH DIFFERENT LEVELS OF CYTOKINES

https://doi.org/10.20996/1819-6446-2016-12-6-685-691

Full Text:

Abstract

Aim. To study possible variants of changes in structural and functional parameters of central hemodynamics in liver cirrhosis classes A, B, C (Child– Pugh) to improve the early diagnostics of extrahepatic complications.

Material and methods. Parameters of central hemodynamics were studied in 107 patients with liver cirrhosis of viral etiology classes A, B, C (ChildPugh) with different levels of serum interleukins (interleukin-2, interleukin-6, tumor necrosis factor alpha).

Results. Significant changes in the central hemodynamics parameters were not revealed in liver cirrhosis of classes A and B. In patients with liver cirrhosis of class С the following significant changes of the left and right heart were found: thickening of the interventricular septum and left ventricular posterior wall up to 12.9Ѓ}1.3 and 13.5Ѓ}1.4 mm respectively; increase in left atrium up to 43.1Ѓ}4.7 mm; right ventricular dilatation up to 38.6Ѓ}4.1 mm and pulmonary artery up to 35.7Ѓ}3.1 mm with an increase in pressure in it up to 35.7Ѓ}3.1 mm Hg. The rate and variants of changes in structural and functional parameters of central hemodynamics correlated with the stages of the liver cirrhosis compensation and the interleukins serum levels.

Conclusion. Changes in parameters of central hemodynamics in liver cirrhosis depends on the stage of compensation. The most pronounced systolic and diastolic myocardial dysfunctions were observed in cirrhosis Class C, with high levels of portal pressure and high concentrations of serum interleukins. Concentric remodeling of the left ventricular and isolated ventricular septal hypertrophy were the worst types of the left ventricular remodeling. These variants of ventricular geometry were accompanied by the most severe impairments of diastolic function.

About the Authors

V. E Kulikov
Ulyanovsk State University
Russian Federation

Vladimir E. Kulikov – MD, PhD, Professor, Chair of Hospital Therapy. 

Lva Tolstogo ul. 42, Ulyanovsk, 432017



T. A. Emelina
Ulyanovsk State University
Russian Federation
Tatyana A. Emelina – MD, Fellow, Chair of Hospital Therapy


O. G. Kazakova
Ulyanovsk State University
Russian Federation
Oxana G. Kazakova – MD, Fellow, Chair of Hospital Therapy


K. V. Nikolaevа
Ulyanovsk State University
Russian Federation
Xenia V. Nikolaeva – MD, Fellow, Chair of Hospital Therapy, Doctor of Ultrasound Diagnostics Department


M. E. Hapman
Ulyanovsk State University
Russian Federation
Marat E. Hapman – MD, PhD, Assistant, Chair of Biology


M. A. Tonеeva
Ulyanovsk State University
Russian Federation
Marina A. Toneva – MD, PhD, Assistant, Chair of Hospital Therapy, Doctor of Ultrasound Diagnostics Department


References

1. Yakovenko E.P., Yakovenko A.V., Kagramanova A.V., et al. Modern approaches to therapy of human with liver cirrhosis. Farmateka. 2012;13:88-93. (In Russ.) [Яковенко Э.П., Яковенко А.В., Каграманова А.В., и др. Современные подходы к терапии больных цирроз печени. Фарматека. 2012;13:88-93].

2. Nazyrov F.G., Devyatov A.V., Babadzhanov A.Kh., Raimov S.A. Peculiarity of development and leaking complication of liver cirrhosis in depending on ethiological factor. Novosti Khirurgii. 2013;4:45-50. (In Russ.) [Назыров Ф.Г., Девятов А.В., Бабаджанов А.Х., Раимов С.А. Особенности развития и течения осложнений цирроза печени в зависимости от этиологического фактора. Новости Хирургии. 2013;4:45-50].

3. Ageev F.T., Ovchinnikov A.G. Diastolic dysfunction as a manifestation of remodeling. Сердечная Недостаточность. 2002;4:190-5. (In Russ.) [Агеев Ф.Т., Овчинников А.Г. Диастолическая дисфункция как проявление ремоделирования сердца. Сердечная Недостаточность. 2002;4:190-5].

4. Dooley J.S., Lok A., Burroughs A.K., Heathcote J., eds. Sherlock's Diseases of the Liver and Biliary System, 12th Edition. Chichester, West Sussex, UK: Wiley-Blackwell; 2011.

5. Mirodzhev G.K., Avezov S.A., Giyasov M.M., Abdullaeva Z.M. Interleykin-6 and nitrogen oxide in pathogenesis of portal hypertensia and a decompensation of cirrhosis. Klinicheskaya Meditsina. 2012;1:4753. (In Russ.) [Мироджев Г.К., Авезов С.А., Гиясов М.М., Абдуллаева З.М. Интерлейкин-6 и оксид азота в патогенезе портальной гипертензии и декомпенсации цирроза печени. Клиническая Медицина. 2012;1:47-53].

6. Elsing С., Harenberg S., Stremmel W., Herrman T. Serum levels of soluble fas, nitric oxide and cytokines in acute decompensated cirrhotic patients. World J Gastroenterol. 2007;13(3):421-5.

7. Chen T.A., Csao T.Y., Chen T.A. Effect of intravenous albumin on endotoxin removal, cytokines, and nitric oxide production in patients with cirrhosis and spontaneous bacterial peritonitis. Scand J Gastroenterol. 2009;44:619-25.

8. Iwakir Y., Groszmann R.J. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule. Hepatology. 2010;43 Suppl.1:122-30.

9. Chen T.A., Csao T.Y., Chen T.A. Effect of intravenous albumin on endotoxin removal, cytokines, and nitric oxide production in patients with cirrhosis and spontaneous bacterial peritonitis. Scand J Gastroenterol. 2011;44(5):619-25.

10. Ivashkin V.T. Complications of portal hypertensia at cirrhosis. Rossiyskiy Fiziologicheskiy Zhurnal. 2009;10:74-6. (In Russ.) [Ивашкин В.Т. Осложнения портальной гипертензии при циррозе печени. Российский Физиологический Журнал. 2009;10:74-6].

11. Mitkov. V.V. Clinical guidelines for ultrasound diagnosis. Moscow: Vidar; 1996. (In Russ.) [Митьков В.В. Клиническое руководство по ультразвуковой диагностике. М.: Видар; 1996].

12. La Villa G., Gentilini P. Hemodynamic alterations in liver cirrhosis. Mol Aspects Med. 2008;29:1139.

13. Nagano T., Yamamoto K., Matsumoto S., et al. Cytokine profile in the liver of primary biliary cirrhosis. J Clin Immunol. 2010;19:422-6.

14. Koksal A.S., Koklű S., Ibic M. Clinical features, serum interleukin-6, and interferon-gamma levels of 34 Turkish patients with hepatoportal sclerosis. Dig Dis Sci. 2009;52(12):3494-7.


For citation:


Kulikov V.E., Emelina T.A., Kazakova O.G., Nikolaevа K.V., Hapman M.E., Tonеeva M.A. POSSIBLE CHANGES IN THE CENTRAL HEMODYNAMICS IN PORTAL HYPERTENSION DUE TO LIVER CIRRHOSIS OF VIRAL ETIOLOGY WITH DIFFERENT LEVELS OF CYTOKINES. Rational Pharmacotherapy in Cardiology. 2016;12(6):685-691. (In Russ.) https://doi.org/10.20996/1819-6446-2016-12-6-685-691

Views: 264


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)