ArticleGut2003
Portopulmonary hypertension in decompensated cirrhosis with refractory ascites.
Article in Gut, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 185 citations in OpenAlex.
- Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II).Wiener klinische Wochenschrift · 2013Guideline
- Pre- and postoperative systemic hemodynamic evaluation in patients subjected to esophagogastric devascularization plus splenectomy and distal splenorenal shunt: a comparative study in schistomomal portal hypertension.World journal of gastroenterology · 2007Trial
- Trial
- Porto-Pulmonary Hypertension in Children: Insights From a National Registry.Pulmonary circulation · 2025Article
- Association of Estimated Plasma Volume Status With Invasive Hemodynamics and All-Cause Mortality in Patients With Liver Cirrhosis.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- From Pathophysiology to Practice: Evolving Pharmacological Therapies, Clinical Complications, and Pharmacogenetic Considerations in Portal Hypertension.Metabolites · 2025Review
- Gut Microbiota and Biomarkers of Endothelial Dysfunction in Cirrhosis.International journal of molecular sciences · 2024Article
- When Pulmonary Arterial Hypertension may be Associated with Portal Hypertension: A Case Report of Two Different Hepatic Disorders in One Patient with Pulmonary Hypertension.Current cardiology reviews · 2024Review
- Bile acid predicts congenital portosystemic venous shunt in patients with pulmonary arterial hypertension.European journal of medical research · 2023Article
- Current clinical understanding and effectiveness of portopulmonary hypertension treatment.Frontiers in medicine · 2023Review
- Shortness of breath due to portopulmonary hypertension and hepatopulmonary syndrome: diagnostic challenges and complex management approach in frail patients.Clinical medicine (London, England) · 2022Article
- Portopulmonary hypertension: Current developments and future perspectives.Liver research (Beijing, China) · 2022Review
- Portopulmonary hypertension and the risk of high right ventricular systolic pressure in liver transplant candidates.PloS one · 2022Article
- The clinical characteristics, treatment, and survival of portopulmonary hypertension in Japan.BMC pulmonary medicine · 2021Observational
- Hepatopulmonary Syndrome and Portopulmonary Hypertension: Current Status and Implications for Liver Transplantation.Current hepatology reports · 2020Article
- Pentadecapeptide BPC 157 resolves Pringle maneuver in rats, both ischemia and reperfusion.World journal of hepatology · 2020Article
- Impact of liver damage on blood-borne variables and pulmonary hemodynamic responses to hypoxia and hyperoxia in anesthetized rats.BMC cardiovascular disorders · 2020Article
- Article
- Macrophage migration inhibitory factor as a novel biomarker of portopulmonary hypertension.Pulmonary circulation · 2016Article
- Pulmonary complications of hepatic diseases.World journal of gastroenterology · 2016Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prevalence of portopulmonary hypertension (PPHTN) in patients with cirrhosis and refractory ascites is unknown. Its presence may preclude patients from receiving a transjugular intrahepatic portosystemic shunt or liver transplantation as a definitive treatment for their end stage cirrhosis. PURPOSE: To determine the prevalence, possible aetiological factors, and predictive factors for the development of PPHTN in these patients.
methodsSixty two patients (53 males, nine females; mean age 54.5 (1.4) years) with biopsy proven cirrhosis and refractory ascites underwent angiographic measurements of pulmonary and splanchnic haemodynamics. Endothelin 1 levels were measured from the pulmonary artery. Forty nine patients underwent radionuclide angiography for measurements of central blood volume, pulmonary vascular, and cardiac chamber volumes. Forty seven patients also underwent two dimensional echocardiography for measurements of cardiac structural and functional parameters. Cardiac output, and systemic and pulmonary vascular resistance were calculated.
resultsTen patients (16.1%) fulfilled the criteria for PPHTN (mean pulmonary artery pressure >/= 25 mm Hg and pulmonary vascular resistance >/= 120 dynxs/cm(5)), with significantly higher mean right atrial (15.4 (1.2) v 7.9 (0.5) mm Hg; p<0.001), and right ventricular pressures (24.7 (1.5) v 14.7 (0.6) mm Hg; p<0.001), and endothelin 1 levels (3.04 (0.40) v 1.98 (0.12) pg/ml; p=0.02). No significant differences in any of the other parameters measured were detected between the two groups. A right atrial pressure of >/= 14 mm Hg had a 83% positive predictive value for the presence of PPHTN.
conclusionsPortopulmonary hypertension is common in cirrhosis with refractory ascites, possibly due to excess endothelin 1 in the pulmonary circulation. An elevated right atrial pressure >/= 14 mm Hg predicts the presence of PPHTN, which may be helpful in deciding management options in these patients.
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